Interaction between sarcopenia and nonalcoholic fatty liver disease

Abstract

Sarcopenia and nonalcoholic fatty liver disease (NAFLD) are common health problems related to aging. Despite the differences in their diagnostic methods, several cross-sectional and longitudinal studies have revealed the close link between sarcopenia and NAFLD. Sarcopenia and NAFLD are linked by several shared pathogenetic mechanisms, including insulin resistance, hormonal imbalance, systemic inflammation, myostatin and adiponectin dysregulation, nutritional deficiencies, and physical inactivity, thus implicating a bidirectional relationship between sarcopenia and NAFLD. However, there is not sufficient data to support a direct causal relationship between sarcopenia and NAFLD. Moreover, it is currently difficult to conclude whether sarcopenia is a risk factor for nonalcoholic steatohepatitis (NASH) or is a consequence of NASH. Therefore, this review intends to touch on the shared common mechanisms and the bidirectional relationship between sarcopenia and NAFLD.

Change in skeletal muscle mass is associated with hepatic steatosis in nonalcoholic fatty liver disease

“…Exercise showed a beneficial effect on functional capacity in patients with NAFLD 38 . Additionally, exercise also reduces muscle loss and prevents progression of sarcopenia 39 , 40 . Therefore, exercise can play an important role as a therapeutic intervention in patients with NAFLD and patients with sarcopenia.…”

Lean vs. obese phenotypes of nonalcoholic fatty liver disease: similar or different?

“…Changes in body weight during follow-up could affect sarcopenia along with aging in patients with NAFLD. 8 A recent large cohort study of 52,815 adult participants reported that 5-year changes in appendicular skeletal muscle mass were significantly higher in participants with NAFLD than in those without NAFLD (-281.3 g vs. -225.2 g). 9 Furthermore, muscle loss was much faster in participants with NAFLD and significant liver fibrosis than in those without.…”

GLP-1 Receptor Agonists in Non-Alcoholic Fatty Liver Disease: Current Evidence and Future Perspectives

“…Furthermore, GLP-1 RAs have been shown to improve muscle wasting both by suppressing myostatin expression and promoting the expression of myogenic factors, as well as through anti-inflammatory and anti-apoptotic effects [ 141 , 142 ]. In light of the bidirectional relationship between NAFLD and sarcopenia and the significantly higher cardiovascular risk in obese sarcopenic patients compared to non-sarcopenic ones [ 143 ], GLP-1 RAs could guarantee additional direct benefits independent from weight loss and glycaemic control.…”