Relationship between Osteosarcopenia and Frailty in Patients with Chronic Liver Disease

Saeki, Chisato; Kanai, Tomoya; Nakano, Masanori; Oikawa, Tsunekazu; Torisu, Yuichi; Abo, Masahiro; Saruta, Masayuki; Tsubota, Akihito

doi:10.3390/jcm9082381

Cited by 27 publications

(29 citation statements)

References 34 publications

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“…However, literature on the prevalence and clinical implications of osteosarcopenia in chronic liver disease remains limited. Seaki et al reported that the prevalence of osteosarcopenia was approximately 20% in patients with chronic liver disease, with osteoporosis increasing the risk of vertebral fracture in these patients ( Table 3 ) [ 189 , 190 ].…”

Section: Osteosarcopeniamentioning

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: Osteosarcopeniamentioning

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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“…Of note, bone disease impacts trabecular bone (i.e., the lumbar spine) more significantly than cortical bone (i.e., femur neck) because of relatively increased turnover in the trabecular bone (38). Bone disease, like sarcopenia, is closely associated with frailty; it also places cirrhotic patients at increased risk for fractures, specifically vertebral fractures, and associated complications such as increased hospital length of stay and 30-day mortality (38,40,41). The risk of post-fracture adverse events was significantly elevated if patients had other clinical complications of cirrhosis, such as ascites (41).…”

Section: Bone Abnormalitiesmentioning

confidence: 99%

A narrative review of nutritional abnormalities, complications, and optimization in the cirrhotic patient

Warner¹,

Aloor²

2022

Transl Gastroenterol Hepatol

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Objective: The purpose of this manuscript is to identify the pathophysiology of the metabolic abnormalities observed in cirrhosis and to uncover associations, if any, to its complications, such as sarcopenia and hepatic encephalopathy (HE).Background: Liver dysfunction in cirrhosis is known to be a precipitating factor in the disruption of many physiological pathways, specifically nutrient metabolism. As a result, affected patients are highly susceptible to derangements of processes affecting multiple classes of macro-and micronutrients, including proteins, carbohydrates, electrolytes, vitamins, and minerals. These disruptions are thought to be contributory to the pathogenesis of known complications of cirrhosis.Methods: Literature research of relevant topics was conducted for the above stated objective; sources were limited to articles from peer-reviewed journals published within the last 30 years.Conclusions: This research established that there is positive correlation between nutrient derangements and the increased risk of complications of cirrhosis, which themselves carry significant morbidity and mortality risk. It also established that some nutrient and electrolyte abnormalities are independent indicators of prognosis and adverse outcomes, such as mortality. This also highlights the importance of comprehension of anomalous metabolism and its complications as it necessitates serious consideration in clinical care. In addition to medical management, cirrhotic patients also require ancillary assessment, such as comprehensive nutritional evaluation, to identify and treat reversible nutritional derangements. This consideration provides the best opportunity to achieve maximal health outcomes in the cirrhotic patient population.

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“…Although both sarcopenia and osteoporosis affect different organs and tissues, they are closely interrelated through common factors, such as genetic factors, endocrine hormones, nutritional status and daily activities [ 27 , 28 ]. LC patients with both osteoporosis and sarcopenia (i.e., osteosarcopenia) have elevated risk of vertebral fractures [ 26 , 29 ].…”

Section: Liver Cirrhosis and Sarcopenia: Pathophysiology And Prognosismentioning

confidence: 99%

Sarcopenia and Frailty in Liver Cirrhosis

Nishikawa

Fukunishi

Asai

et al. 2021

Life

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Skeletal muscle is the largest organ in the body, and skeletal muscle atrophy results from a shift in the balance of protein synthesis and degradation toward protein breakdown. Primary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to aging, and secondary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to underlying diseases. Liver cirrhosis (LC) is one of the representative diseases which can be complicated with secondary sarcopenia. Muscle mass loss becomes more pronounced with worsening liver reserve in LC patients. While frailty encompasses a state of increased vulnerability to environmental factors, there is also the reversibility of returning to a healthy state with appropriate intervention. Several assessment criteria for sarcopenia and frailty were proposed in recent years. In 2016, the Japan Society of Hepatology created assessment criteria for sarcopenia in liver disease. In Japan, health checkups for frailty in the elderly aged 75 years or more started in April 2020. Both sarcopenia and frailty can be adverse predictors for cirrhotic patients. In this review article, we will summarize the current knowledge of sarcopenia and frailty in LC patients.

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Relationship between Osteosarcopenia and Frailty in Patients with Chronic Liver Disease

Cited by 27 publications

References 34 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

A narrative review of nutritional abnormalities, complications, and optimization in the cirrhotic patient

Sarcopenia and Frailty in Liver Cirrhosis

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