FFM and BFM may be associated with serum ALP and AST levels in overweight and obese older adults, while visceral fat area and waist-to-hip ratio showed no independent association with any assessed liver enzymes.
In overweight/obese older adults, each 1.0 kg increase in fat-free mass (FFM) was associated with a decrease in serum alkaline phosphatase (ALP) levels.
In overweight/obese older adults, each 1.0 kg increase in body fat mass (BFM) was associated with an increase in serum aspartate aminotransferase (AST) levels.
Visceral fat area and waist-to-hip ratio showed no independent association with any of the assessed liver enzymes in either weight category.
The study used InBody 770 bioelectrical impedance device to measure anthropometric indices including body fat mass, fat-free mass, visceral fat area, and waist-to-hip ratio.
The authors concluded that prospective and interventional studies are needed to determine whether modifying FFM and BFM can influence liver enzyme concentrations.
This research suggests that body composition — specifically how much muscle (fat-free mass) versus fat (body fat mass) a person carries — may be linked to liver health markers in older adults who are overweight or obese. Among this group, having more muscle mass was associated with lower levels of alkaline phosphatase (ALP), a liver enzyme that can indicate liver stress when elevated. Conversely, having more body fat was associated with slightly higher levels of aspartate aminotransferase (AST), another liver enzyme linked to liver inflammation or damage. Notably, other common measures of body fat distribution — such as visceral fat area (fat around the organs) and waist-to-hip ratio — were not independently associated with liver enzyme levels in this study. The study was conducted as part of the Neyshabur Longitudinal Study on Ageing (NeLSA) in Iran, using precise body composition measurements from a bioelectrical impedance device and standard blood tests for liver enzymes. The participants were older Iranian adults, and the analysis separated them into two groups: underweight/normal weight and overweight/obese. The associations between body composition and liver enzymes were only observed in the overweight/obese group, suggesting these relationships may be weight-dependent. Because this was a cross-sectional study (a snapshot in time), the researchers cannot conclude that changes in body composition directly cause changes in liver enzyme levels. This research suggests that maintaining or building muscle mass while reducing body fat could potentially benefit liver health in older overweight or obese adults, but future long-term and interventional studies are needed to confirm whether actively changing body composition would improve liver enzyme levels.
Hariri M, Heshmati M, Azimi-Nezhad M, Doostparast Torshizi G, Gholami A. (2026). Association between anthropometric indices and serum liver enzyme levels in Iranian older adults: A cross-sectional study based on the Neyshabur Longitudinal Study on Ageing (NeLSA).. Medicine. https://doi.org/10.1097/MD.0000000000051201