Myosteatosis in nonalcoholic fatty liver disease: An exploratory study

T.J.I. De Munck*, P. Verhaegh, T. Lodewick, F. Bakers, D. Jonkers, A.A.M. Masclee, J. Verbeek, G.H. Koek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and aim: Insulin resistance (IR) plays a central role in the complex pathophysiology of nonalcoholic fatty liver disease (NAFLD). IR is linked to fat infiltration in skeletal muscle (myosteatosis) and loss of skeletal muscle mass and function (sarcopenia). The clinical significance of myosteatosis in NAFLD is not well investigated. In this exploratory study we aimed to investigate the association between myosteatosis and NAFLD related hepatic and systemic variables in a well characterized NAFLD cohort.Methods: We cross-sectionally studied forty-five NAFLD patients. The muscle fat fraction (MFF) was measured with chemical shift gradient echo MRI. In addition, the hepatic fat fraction (MRI), liver stiffness (FibroScan) and appendicular skeletal muscle mass (Dual-energy X-ray absorptiometry) were analyzed.Results: The median hepatic fat fraction was 15.64% (IQR 12.05-25.13) and significant (F2-F3) liver fibrosis (liver stiffness >= 7 kPa) was diagnosed in 18 NAFLD patients (40%). MFF was not correlated with hepatic fat fraction (r = -0.035, P = 0.823) and did not differ between subjects with or without significant fibrosis (P = 0.980). No patient was diagnosed with sarcopenia based on the skeletal muscle mass index. In a linear regression model, anthropometric parameters, including body mass index (BMI) (P = 0.018) and total body fat percentage (P = 0.005), were positively associated with MFF while no association with insulin resistance (HOMA-IR) was observed.Conclusion: Myosteatosis did not correlate with the degree of hepatic steatosis or fibrosis in this well characterized NAFLD cohort, but was positively correlated with total body fat percentage and BMI. (C) 2020 Elsevier Masson SAS. All rights reserved.
Original languageEnglish
Article number101500
Number of pages9
JournalClinics and research in hepatology and gastroenterology
Issue number3
Publication statusPublished - 1 May 2021


  • Nonalcoholic fatty liver disease
  • Nonalcoholic steatohepatitis
  • Myosteatosis
  • Hepatic fibrosis
  • Sarcopenia
  • Body composition


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