Liver Cirrhosis and Sarcopenia from the Viewpoint of Dysbiosis

Nishikawa, Hiroki; Enomoto, Hirayuki; Nishiguchi, Shuhei; Iijima, Hiroko

doi:10.3390/ijms21155254

Cited by 33 publications

(42 citation statements)

References 178 publications

(240 reference statements)

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“…In liver cirrhosis, compositional changes in the gut microbiota increased intestinal permeability and endotoxemia, while impairing SCFA production and antioxidant function [ 180 , 181 , 182 ]. These functional changes contributed to the development of sarcopenia through anabolic resistance, chronic inflammation with elevated IL-6 and TNF-α, altered mitochondrial function, as well as oxidative stress [ 3 , 183 ].…”

Section: Sarcopenia In Chronic Liver Diseasementioning

confidence: 99%

An Overview of the Molecular Mechanisms Contributing to Musculoskeletal Disorders in Chronic Liver Disease: Osteoporosis, Sarcopenia, and Osteoporotic Sarcopenia

Kim

2021

IJMS

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The prevalence of osteoporosis and sarcopenia is significantly higher in patients with liver disease than in those without liver disease and osteoporosis and sarcopenia negatively influence morbidity and mortality in liver disease, yet these musculoskeletal disorders are frequently overlooked in clinical practice for patients with chronic liver disease. The objective of this review is to provide a comprehensive understanding of the molecular mechanisms of musculoskeletal disorders accompanying the pathogenesis of liver disease. The increased bone resorption through the receptor activator of nuclear factor kappa (RANK)-RANK ligand (RANKL)-osteoprotegerin (OPG) system and upregulation of inflammatory cytokines and decreased bone formation through increased bilirubin and sclerostin and lower insulin-like growth factor-1 are important mechanisms for osteoporosis in patients with liver disease. Sarcopenia is associated with insulin resistance and obesity in non-alcoholic fatty liver disease, whereas hyperammonemia, low amount of branched chain amino acids, and hypogonadism contributes to sarcopenia in liver cirrhosis. The bidirectional crosstalk between muscle and bone through myostatin, irisin, β-aminoisobutyric acid (BAIBA), osteocalcin, as well as the activation of the RANK and the Wnt/β-catenin pathways are associated with osteosarcopenia. The increased understandings for these musculoskeletal disorders would be contributes to the development of effective therapies targeting the pathophysiological mechanism involved.

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Section: Sarcopenia In Chronic Liver Diseasementioning

confidence: 99%

An Overview of the Molecular Mechanisms Contributing to Musculoskeletal Disorders in Chronic Liver Disease: Osteoporosis, Sarcopenia, and Osteoporotic Sarcopenia

Kim

2021

IJMS

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“…Liver cirrhosis (LC) is the end-stage form of chronic liver disease (CLD) and presents with a variety of complications. Liver cirrhosis (LC) is a representative disease that causes secondary sarcopenia [ 5 ]. LC leads to secondary sarcopenia, due to characteristic conditions such as protein-energy malnutrition (PEM).…”

Section: Sarcopenia and Sarcopenic Obesity In Liver Cirrhosismentioning

confidence: 99%

“…In cirrhotic patients, fasting for only 6–10 h is equivalent to fasting for 2–3 days in healthy individuals, which is also associated with the development of sarcopenia [ 6 ]. In LC patients, there is an amino acid imbalance with the decrease of branched-chain amino acids (BCAAs) and increase of aromatic amino acids [ 5 ]. BCAAs are amino acids that are metabolized by muscles, to detoxify ammonia, and are a good source of energy for the liver [ 5 ].…”

Section: Sarcopenia and Sarcopenic Obesity In Liver Cirrhosismentioning

confidence: 99%

“…In LC patients, there is an amino acid imbalance with the decrease of branched-chain amino acids (BCAAs) and increase of aromatic amino acids [ 5 ]. BCAAs are amino acids that are metabolized by muscles, to detoxify ammonia, and are a good source of energy for the liver [ 5 ]. BCAAs were found to improve homeostasis model assessment of insulin resistance (HOMA-IR) scores and the function of beta cells in CLD patients [ 7 ].…”

Section: Sarcopenia and Sarcopenic Obesity In Liver Cirrhosismentioning

confidence: 99%

“…Oxidative stress can damage mitochondria and nuclear DNA, stimulate apoptosis, and lead to muscle fiber atrophy and myocyte loss [ 39 ]. Dysbiosis indicates a state where the diversity of gut microbiota and the number of bacteria in the gut are reduced [ 5 ]. LC associated dysbiosis also induces oxidative stress [ 5 ].…”

Section: Molecular Mechanism and Liver Diseasesmentioning

confidence: 99%

See 2 more Smart Citations

Sarcopenic Obesity in Liver Cirrhosis: Possible Mechanism and Clinical Impact

Nishikawa

Enomoto

Nishiguchi

et al. 2021

IJMS

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: The picture of chronic liver diseases (CLDs) has changed considerably in recent years. One of them is the increase of non-alcoholic fatty liver disease. More and more CLD patients, even those with liver cirrhosis (LC), tend to be presenting with obesity these days. The annual rate of muscle loss increases with worsening liver reserve, and thus LC patients are more likely to complicate with sarcopenia. LC is also characterized by protein-energy malnutrition (PEM). Since the PEM in LC can be invariable, the patients probably present with sarcopenic obesity (Sa-O), which involves both sarcopenia and obesity. Currently, there is no mention of Sa-O in the guidelines; however, the rapidly increasing prevalence and poorer clinical consequences of Sa-O are recognized as an important public health problem, and the diagnostic value of Sa-O is expected to increase in the future. Sa-O involves a complex interplay of physiological mechanisms, including increased inflammatory cytokines, oxidative stress, insulin resistance, hormonal disorders, and decline of physical activity. The pathogenesis of Sa-O in LC is diverse, with a lot of perturbations in the muscle–liver–adipose tissue axis. Here, we overview the current knowledge of Sa-O, especially focusing on LC.

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Analysis of intestinal flora in elderly Uygur patients with sarcopenia

Shan,

Cheng,

Zhu

et al. 2024

Immunity Inflam & Disease

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ObjectiveThis study was designed to analyze the structural characteristics of the intestinal flora of elderly Uygur patients with sarcopenia, thereby providing new ideas for clinical treatment.MethodsFirstly, fecal samples were collected from 40 elderly Uygur patients with sarcopenia (Sarcopenia group) and 40 healthy people (Control group). Next, significant differences in the intestinal flora between the two groups were analyzed based on 16S rDNA high‐throughput sequencing. The linear discriminant analysis effect size (LEfSe) was used to estimate the magnitude of the effect of each component (species) abundance on the differential effect. Additionally, an analysis was also performed on the relationship between the intestinal flora and the cytokines in the peripheral blood of patients with sarcopenia.ResultsThe results of β diversity showed that there were differences in the structure of the intestinal flora between the two groups. Besides, the phylum level of intestinal flora between the two groups was not significantly different. However, the difference was significant in the intestinal flora at the order, family, and genus levels between the two groups. Among them, Lachnoclostridium, Photobacterium, Anaerobic Bacillus, Hydrogenophilus, and Eubacterium were enriched in the Sarcopenia group; Prevotella 9, Firmicutes FCS020 group, Streptobacillus, Aggregatibacter, Corynebacterium, Clostridium Difficile, and Haloanaerobium were enriched in the Control group. The LEfSe outcomes further showed that Lachnoclostridium was highly enriched in the Sarcopenia group; Prevotella 9 and Firmicutes FCS020 group were significantly enriched in the Control group. Furthermore, the relative abundance of Lachnoclostridium and Streptobacillus were significantly different in patients with high and low IL‐6 levels.ConclusionIn conclusion, Lachnoclostridium is significantly enriched in the intestines of elderly Uygur patients with sarcopenia; the increase in Lachnoclostridium abundance and the decrease in Streptobacillus abundance are associated with high levels of IL‐6. Therefore, abnormal intestinal flora is related to inflammatory reflexes in patients with sarcopenia.

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Liver Cirrhosis and Sarcopenia from the Viewpoint of Dysbiosis

Cited by 33 publications

References 178 publications

An Overview of the Molecular Mechanisms Contributing to Musculoskeletal Disorders in Chronic Liver Disease: Osteoporosis, Sarcopenia, and Osteoporotic Sarcopenia

An Overview of the Molecular Mechanisms Contributing to Musculoskeletal Disorders in Chronic Liver Disease: Osteoporosis, Sarcopenia, and Osteoporotic Sarcopenia

Sarcopenic Obesity in Liver Cirrhosis: Possible Mechanism and Clinical Impact

Analysis of intestinal flora in elderly Uygur patients with sarcopenia

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