Metabolic-associated fatty liver disease and sarcopenia: A double whammy

Abstract

The prevalence of metabolic-associated fatty liver disease (MAFLD) has increased substantially in recent years because of the global obesity pandemic. MAFLD, now recognized as the number one cause of chronic liver disease in the world, not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnoea, lipid disorders and sarcopenia. Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies. Sarcopenia can be either part of the disease process that results in MAFLD (e.g. , obesity or adiposity) or a consequence of MAFLD, especially in the advanced stages such as fibrosis and cirrhosis. Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors. Therefore, it is crucial to thoroughly understand how we deal with these diseases, especially when they coexist. We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.

Sarcopenia and metabolic dysfunction associated steatotic liver disease: Time to address both

“…Both sarcopenia and MASLD are associated with significant health risks, as pointed out by Viswanath et al [ 1 ] in their review. Therefore, early identification and adequate diagnosis are important.…”

“…Both MASLD and sarcopenia are closely intertwined, as Viswanath et al [ 1 ] summarizes. Pathophysiologically, insulin resistance is believed to play a common role in the development of both diseases.…”

“…With increasing incidence of metabolic dysfunction associated steatotic liver disease (MASLD) and the increasing age of the population, sarcopenia has been closely studied as one of the pathophysiologic conditions at play in the development and progression of MASLD. A comprehensive review published by Viswanath et al [ 1 ] closely examines the relationship between these two diagnoses. It highlights numerous shared risk factors, such as elevated lipid profile, physical inactivity, and diabetes mellitus, that suggest a bidirectional relationship between MASLD and sarcopenia.…”

Triglyceride-Targeted Molecularly Imprinted Polymers Activate Lipophagy via Cargo Exchange for Nonalcoholic Fatty Liver Disease Treatment

“…44 Sarcopenia may be part of a disease process leading to NAFLD (e.g., obesity) or it may be a consequence of NAFLD and further aggravate NAFLD, especially in advanced stages such as fibrosis and cirrhosis. 45 Sarcopenia is present even in the early stages of liver disease and worsens with the severity of liver disease. Sarcopenia and NAFLD involve common pathogenic mechanisms, with fat infiltration and deposition inducing chronic inflammation, insulin resistance, oxidative stress, and alterations in adipokines and myokines, ultimately leading to cellular steatosis.…”

“…Of these, sarcopenia is the infiltration of fat into skeletal muscle, leading to the functional decline and loss of skeletal muscle mass seen in sarcopenia . Sarcopenia may be part of a disease process leading to NAFLD (e.g., obesity) or it may be a consequence of NAFLD and further aggravate NAFLD, especially in advanced stages such as fibrosis and cirrhosis …”