Associations of Hand-Grip Strength and Arm Muscle Mass Index Relative to Body Weight with Risk of Non-Alcoholic Fatty Liver Disease in Wheelchair Users.

Background: This study examined the independent and combined associations of hand-grip strength (HGS) and arm muscle mass index with risk of non-alcoholic fatty liver disease (NAFLD) in individuals who use wheelchairs. Methods: Eighty-five individuals aged ≥ 30 years who use wheelchairs were enrolled as volunteers from sports welfare facilities for individuals with disabilities in "G" and "C" provinces. HGS was measured using a dynamometer, whereas the arm muscle mass index was assessed using a body composition analyzer. Risk of NAFLD was defined as a hepatic steatosis index (HSI) > 36 and Framingham steatosis index (FSI) ≥ 23. Results: The low-HGS group (HSI, odds ratio [OR] = 3.589, p = 0.013; FSI, OR = 2.710, p = 0.031) had a significantly higher NAFLD risk compared to the high-HGS group (reference, OR = 1). The low-arm-muscle-mass-index group showed a higher risk of NAFLD (HSI, OR = 2.762, p = 0.043; FSI, OR = 3.493, p = 0.007) compared to the high-arm-muscle-mass-index group (reference, OR = 1). Combining the low-HGS + low-arm-muscle-mass-index group (HSI, OR = 6.849, p = 0.006; FSI, OR = 6.957, p = 0.002) showed a significantly higher risk of NAFLD compared to the high-HGS + high-arm-muscle-mass-index group (reference, OR = 1), even after adjusting for covariates (HSI, OR = 7.352, p = 0.006; FSI, OR = 7.406, p = 0.003). Conclusions: Low HGS and low arm muscle mass index are independently associated with a higher risk of NAFLD in individuals who use wheelchairs, with low HGS plus low arm muscle mass index further increasing this risk.