# Association Between Sarcopenic Obesity–Related Scores and Liver Fibrosis in Patients with Steatotic Liver Disease: A Cross-Sectional Study

## TL;DR

This study finds that sarcopenic obesity is linked to more severe liver fibrosis in patients with steatotic liver disease.

## Contribution

The study introduces new cutoff values for sarcopenic obesity and dGFR to assess liver fibrosis in steatotic liver disease.

## Key findings

- Sarcopenic obesity (mSpOb) is associated with higher rates of advanced liver fibrosis in MASLD and ALD.
- Specific BMI and grip strength cutoffs differ between men and women for identifying sarcopenic obesity.
- Sp-dGFR cutoffs correlate with advanced fibrosis in MASLD patients.

## Abstract

Background/Objectives: Sarcopenia (Sp) and obesity (Ob) have significant negative effects on steatotic liver disease (SLD). Here, we examined the effects of sarcopenic Ob (SO) on liver fibrosis in patients with SLD. Methods: We included 811 patients who visited our outpatient clinic and underwent FibroScan (Echosens, France). Liver stiffness (LS) was assessed using body mass index (BMI) and grip strength (GS). We conducted a similar analysis by converting the difference in estimated glomerular filtration rate (dGFR) based on creatinine and cystatin C levels into GS. Results: The cutoff values for distinguishing metabolic dysfunction-associated steatotic liver disease (MASLD; 298 patients) with LS > 10 kPa (advanced fibrosis) were set separately for men and women using receiver operating characteristic analysis. BMI was set at >26 kg/m2 in women and >27 kg/m2 in men (modified Ob (mOb)), and GS was set at <16 kg in women and <31 kg in men (modified Sp (mSp)). The ratio of advanced fibrosis was higher in the group with both mSp and mOb (mSpOb) than in the group with mSp alone or mOb alone in MASLD or alcoholic liver disease (ALD, 97 patients). However, this association has not yet been observed in other diseases. The dGFR was used to set the cutoff value corresponding to advanced fibrosis. Sp-dGFR (SpdG) was >1.14 in women and >−0.76 in men in the MASLD group. mSpOb, SpdG and Ob are associated with advanced fibrosis in MASLD logistic regression analysis. Conclusions: SO, assessed using BMI and GS or dGFR, was associated with elevated LS in patients with SLD.