Journal of Gastroenterology

, Volume 54, Issue 2, pp 160–170 | Cite as

Increase in the skeletal muscle mass to body fat mass ratio predicts the decline in transaminase in patients with nonalcoholic fatty liver disease

  • Naoki Mizuno
  • Yuya SekoEmail author
  • Seita Kataoka
  • Keiichiroh Okuda
  • Mitsuhiro Furuta
  • Masashi Takemura
  • Hiroyoshi Taketani
  • Tasuku Hara
  • Atsushi Umemura
  • Taichiro Nishikawa
  • Kanji Yamaguchi
  • Michihisa Moriguchi
  • Yoshito Itoh
Original Article—Liver, Pancreas, and Biliary Tract



The aim of this retrospective study was to determine the effect of skeletal muscle and body fat on liver function in patients with nonalcoholic fatty liver disease (NAFLD) diagnosed by liver biopsy.


Among the 219 patients with NAFLD enrolled in this study was a cohort of 139 patients who had their body composition measured with Inbody720 at baseline and at ≥ 1 year postbaseline, to elucidate the relationship between liver function and changes in skeletal muscle and body fat mass. Multivariate analysis was used to identify factors influencing low skeletal muscle mass index (SMI, defined as 7 kg/m2 in men, and 5.7 kg/m2 in women) and the skeletal muscle mass to body fat mass ratio (SF ratio).


Of the 219 patients enrolled, 27 (12.3%) had a low SMI. Patient age (> 70 years) and female gender were identified as risk factors for low SMI. Hepatic fibrosis was not associated with SMI. In the cohort followed up at baseline and 12 months later, transaminase activity, body fat mass, and SMI significantly decreased over time. Changes in the SF ratio were significantly associated with changes in liver function. An increase in the SF ratio [hazard ratio (HR) 10.99 in men, 6.849 in women] was a predictor of reduced ALT, independent of age and other backgrounds.


In the patients with NAFLD, SMI was decreased, even in the early stages of NAFLD. Therapeutic strategies for NAFLD require a reduction in body fat mass and the maintenance of skeletal muscle is also needed.


Body fat mass NAFLD SMI SF ratio 



Alanine aminotransferase


Aspartate aminotransferase


Body fat mass index


Body mass index


Basal metabolic rate


Confidence interval


Fasting plasma glucose


γ Glutamyl transpeptidase


Hemoglobin A1c


High-density lipoprotein cholesterol


Hazard ratio

SF ratio

SMI to BFMI ratio


Low-density lipoprotein cholesterol


Nonalcoholic fatty liver disease


NAFLD activity score


Nonalcoholic steatohepatitis


Skeletal mass index



Financial support: This study was not supported by any institution funding.

Compliance with ethical standards

Conflict of interest

The authors do not have any disclosures to report.

Supplementary material

535_2018_1485_MOESM1_ESM.pptx (69 kb)
Supplement Figure 1. Correlations between changes in AST, ALT, and SF ratio. (PPTX 69 kb)
535_2018_1485_MOESM2_ESM.docx (21 kb)
Supplementary material 2 (DOCX 20 kb)


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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  • Naoki Mizuno
    • 1
  • Yuya Seko
    • 1
    Email author
  • Seita Kataoka
    • 1
  • Keiichiroh Okuda
    • 1
  • Mitsuhiro Furuta
    • 1
  • Masashi Takemura
    • 1
  • Hiroyoshi Taketani
    • 1
  • Tasuku Hara
    • 1
  • Atsushi Umemura
    • 1
  • Taichiro Nishikawa
    • 1
  • Kanji Yamaguchi
    • 1
  • Michihisa Moriguchi
    • 1
  • Yoshito Itoh
    • 1
  1. 1.Department of Gastroenterology and HepatologyKyoto Prefectural University of MedicineKyotoJapan

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