Diabetes, obesity & metabolism · 2026
Changes in Muscle Mass and the Risk of Liver-Related Events: A Prospective Cohort Study.
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Gui Zihao, Duan Hualin, Yu Qingtao, Chen Junnian, Cao Huanyi, Liu Siyang, Liu Lan, Shen Jie, Wan Heng
Аннотация
BACKGROUND AND AIMS: Previous studies found that lower muscle mass at baseline was an important risk factor for liver-related events (LRE), yet evidence on longitudinal muscle mass changes remains limited. This study examines associations between changes in muscle mass and incident LRE.
METHODS: This prospective cohort study included 19 660 participants with baseline and first follow-up body composition data. Appendicular skeletal muscle mass (ASM) was estimated using bioelectrical impedance analysis and the Janssen equation, and was indexed to body mass index as ASM/BMI. ΔASM/BMI was calculated as ASM/BMI at first follow-up minus ASM/BMI at baseline. Follow-up for incident LRE started at the first follow-up assessment. Cox proportional hazards models, restricted cubic spline analyses, subgroup analyses, competing-risk models, and sensitivity analyses were performed.
RESULTS: During a median follow-up of 9.87 years, 101 incident LRE were identified. In the fully adjusted model, higher ΔASM/BMI was associated with a lower risk of incident LRE. Compared with participants in the lowest tertile, those in the intermediate and highest tertiles had lower LRE risk, with HRs of 0.59 (95% CI, 0.37-0.94) and 0.44 (95% CI, 0.27-0.72), respectively. The association was more pronounced among participants younger than 60 years (p for interaction = 0.042). Restricted cubic spline analysis showed a significant nonlinear association between ΔASM/BMI and LRE risk (P-overall = 0.012; p-non-linear = 0.029). Results were generally consistent in competing-risk, sensitivity, propensity score-based, and nested case-control analyses.
CONCLUSION: Greater preservation or increase in muscle mass was associated with a lower risk of incident LRE, particularly among participants younger than 60 years. These findings support the potential relevance of maintaining muscle mass for liver risk stratification.
METHODS: This prospective cohort study included 19 660 participants with baseline and first follow-up body composition data. Appendicular skeletal muscle mass (ASM) was estimated using bioelectrical impedance analysis and the Janssen equation, and was indexed to body mass index as ASM/BMI. ΔASM/BMI was calculated as ASM/BMI at first follow-up minus ASM/BMI at baseline. Follow-up for incident LRE started at the first follow-up assessment. Cox proportional hazards models, restricted cubic spline analyses, subgroup analyses, competing-risk models, and sensitivity analyses were performed.
RESULTS: During a median follow-up of 9.87 years, 101 incident LRE were identified. In the fully adjusted model, higher ΔASM/BMI was associated with a lower risk of incident LRE. Compared with participants in the lowest tertile, those in the intermediate and highest tertiles had lower LRE risk, with HRs of 0.59 (95% CI, 0.37-0.94) and 0.44 (95% CI, 0.27-0.72), respectively. The association was more pronounced among participants younger than 60 years (p for interaction = 0.042). Restricted cubic spline analysis showed a significant nonlinear association between ΔASM/BMI and LRE risk (P-overall = 0.012; p-non-linear = 0.029). Results were generally consistent in competing-risk, sensitivity, propensity score-based, and nested case-control analyses.
CONCLUSION: Greater preservation or increase in muscle mass was associated with a lower risk of incident LRE, particularly among participants younger than 60 years. These findings support the potential relevance of maintaining muscle mass for liver risk stratification.