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However, no studies have been published that assess the influence of longitudinal changes in SV ratio on the features of NAFLD. Thus, it is likely that a low SV ratio aggravates the risk of NAFLD onset and is an important factor for the progression of hepatic fibrosis. 9 When SV ratio was stratified using quartiles, the group with the lowest SV ratio were more likely to worsen NAFLD pathophysiological conditions such as insulin resistance, adipokine imbalance, and inflammatory or oxidative stress, leading to the exacerbation of hepatic function, hepatocyte apoptosis, and liver fibrosis. Recently, we reported on the cross-sectional study that a low skeletal muscle mass to visceral fat area ratio (SV ratio), 8 an index of sarcopenic obesity, is related to exacerbation of the hepatic conditions in NAFLD eg, moderate to severe steatosis and advanced fibrosis. Therefore, both increases in abdominal fat and decreases in skeletal muscle mass are being increasingly shown to be important factors affecting the pathophysiology and survival outcome of those presented with chronic liver disease. 7īased on the clinical findings above, alterations in body composition caused by an obesity-related increase in abdominal fat and a decrease in skeletal muscle mass are believed to be elements related to the onset and exacerbation of chronic liver diseases, in addition to the survival outcome of chronic liver disease patients. 3, 4 However, it also heightens the probability of developing NAFLD 5 – 7 and exacerbating liver fibrosis. 2 Low skeletal muscle mass is also an independent prognostic factor for hepatocellular carcinoma. 2 This may be because a reduction in exercise tolerance secondary to loss of skeletal muscle mass accelerates the progression of chronic liver disease to cirrhosis. 1 The relation between low skeletal muscle mass (sarcopenia) and poor survival outcome of patients with chronic liver disease has also been published previously. Abnormal body composition, such as obesity coupled with low skeletal muscle mass, reportedly affects the pathophysiology of chronic liver disease.

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