| Summary: | <i>Background and Objectives</i>: Recent studies have shown that low skeletal muscle mass can contribute to non-alcoholic fatty liver disease through insulin resistance. However, the association between muscle mass/strength and hepatic fat content remains unclear in postmenopausal women. <i>Methods</i>: In this study, we assessed the associations between muscle mass/strength and various severities of non-alcoholic fatty liver disease. Using single-voxel proton magnetic resonance spectroscopy, 96 postmenopausal women between the ages of 50 and 65 were divided into four groups (G0−G3) by hepatic fat content: G0 (hepatic fat content <5%, <i>n</i> = 20), G1 (5% ≤ hepatic fat content < 10%, <i>n</i> = 27), G2 (10% ≤ hepatic fat content < 25%, <i>n</i> = 31), and G3 (hepatic fat content ≥25%, <i>n</i> = 18). Muscle mass indexes were estimated as skeletal muscle index (SMI)% (total lean mass/weight × 100) and appendicular skeletal muscular mass index (ASM)% (appendicular lean mass/weight × 100) by dual energy X-ray absorptiometry. Maximal isometric voluntary contraction of the handgrip, elbow flexors, and knee extensors was measured using an adjustable dynamometer chair. Fasting plasma glucose, insulin, and follicle-stimulating hormones were assessed in venous blood samples. <i>Results</i>: The results showed negative correlations between hepatic fat content and SMI% (r = −0.42, <i>p</i> < 0.001), ASM% (r = −0.29, <i>p</i> = 0.005), maximal voluntary force of grip (r = −0.22, <i>p</i> = 0.037), and knee extensors (r = −0.22, <i>p</i> = 0.032). <i>Conclusions</i>: These significant correlations almost remained unchanged even after controlling for insulin resistance. In conclusion, negative correlations exist between muscle mass/strength and the progressed severity of non-alcoholic fatty liver disease among post-menopausal women, and the correlations are independent of insulin resistance.
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