{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:37:38Z","timestamp":1793144258518,"version":"4.5.0"},"reference-count":48,"publisher":"The Korean Association for the Study of the Liver","issue":"4","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-cmh.org"],"crossmark-restriction":true},"short-container-title":["Clin Mol Hepatol"],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:p>Background\/Aims: To investigate whether non-alcoholic fatty liver disease (NAFLD) in individuals without generalized obesity is associated with visceral fat obesity (VFO), sarcopenia, and\/or myosteatosis.Methods: This cross-sectional analysis included 14,400 individuals (7,470 men) who underwent abdominal computed tomography scans during routine health examinations. The total abdominal muscle area (TAMA) and skeletal muscle area (SMA) at the 3&lt;sup&gt;rd&lt;\/sup&gt; lumbar vertebral level were measured. The SMA was divided into the normal attenuation muscle area (NAMA) and low attenuation muscle area, and the NAMA\/TAMA index was calculated. VFO was defined by visceral to subcutaneous fat ratio, sarcopenia by body mass index-adjusted SMA, and myosteatosis by the NAMA\/TAMA index. NAFLD was diagnosed with ultrasonography.Results: Of the 14,400 individuals, 4,748 (33.0%) had NAFLD, and the prevalence of NAFLD among non-obese individuals was 21.4%. In regression analysis, both sarcopenia (men: odds ratio [OR] 1.41, 95% confidence interval [CI] 1.19\u20131.67, P&lt;0.001; women: OR=1.59, 95% CI 1.40\u20131.90, P&lt;0.001) and myosteatosis (men: OR=1.24, 95% CI 1.02\u20131.50, P=0,028; women: OR=1.23, 95% CI 1.04\u20131.46, P=0.017) were significantly associated with non-obese NAFLD after considering for VFO and other various risk factors, whereas VFO (men: OR=3.97, 95% CI 3.43\u20134.59 [adjusted for sarcopenia], OR 3.98, 95% CI 3.44\u20134.60 [adjusted for myosteatosis]; women: OR=5.42, 95% CI 4.53\u20136.42 [adjusted for sarcopenia], OR=5.33, 95% CI 4.51\u20136.31 [adjusted for myosteatosis]; all P&lt;0.001) was strongly associated with non-obese NAFLD after adjustment with various known risk factors.Conclusions: In addition to VFO, sarcopenia and\/or myosteatosis were significantly associated with non-obese 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