Evaluation of the correlations of FIB4 index for liver fibrosis with bioelectrical impedance measurements and hand grip strength in female patients with nonalcoholic fatty liver disease

Abstract

Objective: A rapid increase in cases of nonalcoholic fatty liver disease (NAFLD) has become a clinical problem in recent years, and the fibrosis-4 (FIB4) index has been developed as a noninvasive method for evaluating liver stiffness. However, this method requires expensive medical equipment, so the development of an inexpensive evaluation method is desired. We examined whether bioelectrical impedance analysis (BIA) and hand grip strength measurement can be used to evaluate hepatic fibrosis in female NAFLD.

Participants and Methods: Between September 2014 and December 2016, 21 consecutive patients clinically diagnosed with NAFLD in our hospital by laboratory data and abdominal imaging were enrolled in this study. BIA and hand grip strength measurements were performed. We examined the correlations of the FIB4 index reflecting liver fibrosis with each item measured by BIA (phase angle, body cell mass, extracellular water / total body water ratio, skeletal muscle index, percent body fat, lower limb / upper limb muscle mass ratio) and with hand grip strength.

Results: The FIB4 index showed significant negative correlations with phase angle (r = -0.758, p < 0.0001) and between hand grip strength (r = -0.777, p < 0.0001) . The FIB4 index also showed a weak correlation with the following: body cell mass, ratio of extracellular water to total body water, and muscle mass ratio of the lower to upper limbs.

Conclusion: In female NAFLD, phase angle and hand grip strength may be useful for the simple evaluation of liver fibrosis.