P-8 OSTEOSARCOPENIA AND FIBROSIS SEVERITY IN NON-ALCOHOLIC FATTY LIVER DISEASE

Introduction and Objectives

Both osteosarcopenia and non-alcoholic fatty liver disease (NAFLD) are subject to complex and interconnected pathophysiological processes. This study aimed to assess the osteosarcopenia frequency in NAFLD and its association with liver fibrosis.

Materials and Methods

Adults with established risk factors for the development of NAFLD were selected. Assessment of NAFLD and degrees of fibrosis was performed by ultrasound (US-FLI) and ultrasound elastography. Quantitative assessment of muscle mass and bone mass density (BMD) were measured with dual energy X-ray absorptiometry (DXA). Low BMD was defined as established by WHO. Appendicular lean mass (ALM), representing the sum of lean mass at upper and lower limbs; appendicular lean mass index (ALMI: ALM/height2). Sarcopenia if ALMI <7.0 kg/m2 men or <5.5 kg/m2 women.

Results

73 participants were enrolled, and hepatic steatosis was present in 58. All data are presented as median (IQR) or n (%). Age 63 (53-67) years, women 59(80.8%), 25(OH)D3 levels 26(22- 31) ng/mL. The frequency of liver fibrosis (F 2), low levels of vitamin D (<20 ng/mL) and sarcopenia was, respectively: 16(22%), 14(19%), 6(8%). We found low BMD in 43 (59%), of these 6(14%) osteoporosis, 35(81.4%) osteopenia and 2(4.6%) low BMD for age. The groups with and without fibrosis did not show differences in the levels or frequency of vitamin D deficiency or sarcopenia. However, participants with fibrosis had lower T-score and lower BMD in the lumbar spine and hip when compared to participants without fibrosis, p<0.05.

Conclusions

Our data suggest that the frequency of low BMD is higher in the population with NAFLD and high incidence of liver fibrosis than in the general Brazilian population. Evaluating by DXA, we observed that patients with liver fibrosis have lower bone mass, but not less muscle mass compared to patients without fibrosis.