Association between systemic immune-inflammation index and skeletal muscle mass in patients with nonalcoholic fatty liver disease: A cross-sectional study

Medicine (Baltimore). 2026 Nov 13;105(46):e51462. doi: 10.1097/MD.0000000000051462.

ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive liver fat accumulation, which is associated with inflammatory responses and metabolic disruptions that may affect skeletal muscle mass. However, the specific relationship between the systemic immune-inflammation index (SII) and skeletal muscle mass in NAFLD patients remains unclear. We conducted a cross-sectional analysis using data from the 2017 to 2018 National Health and Nutrition Examination Survey. The study comprised 673 adults with confirmed NAFLD who met inclusion criteria and had complete data on SII and skeletal muscle mass. Generalized weighted linear regression models were employed to assess the association, with adjustment for multiple covariates including demographic, socioeconomic, and clinical factors. After controlling for covariates, regression analysis revealed a significant independent negative correlation between SII and muscle mass (β = -0.037, 95% confidence interval [CI] = -0.055 to -0.019, P < .001). Smooth curve analysis indicated an approximately linear relationship, with an inflection point at 536.63 (1000 cells/μL). Subgroup analyses showed more pronounced negative correlations in males (β = -0.045, 95% CI = -0.073 to -0.018, P = .001) and non-Hispanic white individuals (β = -0.129, 95% CI = -0.193 to -0.065, P < .001). Our findings provide evidence of an independent negative association between SII and skeletal muscle mass in NAFLD patients, suggesting that systemic immune inflammation may contribute to muscle loss in this population.

PMID:43024322 | DOI:10.1097/MD.0000000000051462