Sarcopenia in Chronic Liver Disease: A Metabolic Perspective

Kumar, Ramesh; Prakash, Sabbu Surya; Priyadarshi, Rajeev Nayan; Anand, Utpal

doi:10.14218/jcth.2022.00239

Cited by 13 publications

(11 citation statements)

References 122 publications

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“…In addition, the upregulation of gluconeogenesis also results in a low concentration of skeletal muscle amino acids, leading to muscle wasting. Thus, this aggressive feedback loop worsens the disease ( 51 ). During muscle atrophy, the activity of the glycolytic enzymes is increased in the muscle, while gluconeogenesis is increased in the liver ( 52 ).…”

Section: Discussionmentioning

confidence: 99%

β‑carotene attenuates muscle wasting in cancer cachexia by regulating myogenesis and muscle atrophy

Kim,

Oh,

Kim

et al. 2023

Oncol Rep

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Cancer cachexia is a metabolic disease involving multiple organs, which is accompanied by the depletion of muscle tissue and is associated with ~20% of cancer-related deaths. Muscle wasting is a critical factor in cancer cachexia. β-carotene (BC) has been shown to increase muscle mass and hypertrophy in healthy mice. However, its effects on muscle tissue dysregulation in cancer cachexia have yet to be studied. In the present study, 5-week-old male C57BL/6J mice were injected with 1×10 6 Lewis lung carcinoma (LLC) cells to induce cancer cachexia; then the mice were administered BC (4 or 8 mg/kg) for 22 days to assess its effects on muscle atrophy in the gastrocnemius muscles. The effects of BC on inflammatory cytokines, myogenesis and muscle atrophy were evaluated using C2C12 myotubes treated with LLC-conditioned media. BC supplementation significantly suppressed tumor growth, inflammatory cytokines, and hepatic gluconeogenesis in the LLC-induced cancer cachexia mouse model, while also improving muscle weight and grip strength. These effects are considered to be mediated by the PI3K/Akt pathway and through regulation of muscle atrophy. Moreover, BC treatment was associated with the recovery of LLC-conditioned media-induced muscle differentiation deficits and muscle atrophy in C2C12 myotubes. These findings indicate BC as a potential novel therapeutic agent for cancer cachexia.

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Section: Discussionmentioning

confidence: 99%

β‑carotene attenuates muscle wasting in cancer cachexia by regulating myogenesis and muscle atrophy

Kim,

Oh,

Kim

et al. 2023

Oncol Rep

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“…Nutritional disorders, low levels of branched-chain amino acids (BCAAs), hyperammonemia, abnormal gut microbiota, insulin resistance, and lipid factors are thought to contribute to sarcopenia in patients with chronic liver disease [ 15 ]. Cirrhosis, a terminal manifestation of chronic liver disease, often results in protein-energy malnutrition (PEM).…”

Section: Sarcopenia In Chronic Liver Diseasementioning

confidence: 99%

Impact of Sarcopenia on Non-Alcoholic Fatty Liver Disease

et al. 2023

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With the increasing incidence of non-alcoholic fatty liver disease (NAFLD) and the aging of the population, sarcopenia is attracting attention as one of the pathological conditions involved in the development and progression of NAFLD. In NAFLD, sarcopenia is closely associated with insulin resistance and results from the atrophy of skeletal muscle, an insulin target organ. In addition, inflammatory cytokines that promote skeletal muscle protein breakdown, low adiponectin levels leading to decreased insulin sensitivity, and hyperleptinemia are also involved in NAFLD pathogenesis. The presence of sarcopenia is a prognostic factor and increases the risk of mortality in patients with cirrhosis and post-treatment liver cancer. Sarcopenia, the presence of which mainly occurs due to decreased muscle mass, combined with increased visceral fat, can lead to sarcopenia-associated obesity, which increases the risk of NASH, liver fibrosis, and cardiovascular disease. In order to treat sarcopenia, it is necessary to properly evaluate sarcopenia status. Patients with high BMI, as in sarcopenic obesity, may improve with caloric restriction. However, inadequate oral intake may lead to further loss of muscle mass. Aerobic and resistance exercise should also be used appropriately.

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“…Severe salt restriction makes the food unpalatable and alters dietary patterns, which might promote protein-calorie malnutrition and increase mortality risk[ 4 , 20 , 21 ]. Notably, malnutrition and sarcopenia are already prevalent in patients with advanced cirrhosis[ 22 , 23 ]. In a study of cirrhotic patients with ascites requiring repeated paracentesis, salt restriction without nutritional support resulted in a 3.9-fold higher risk of mortality within one year, compared to that of unrestricted sodium intake with nutritional support[ 13 ].…”

Section: Salt and Cirrhosis: Important Issuesmentioning

confidence: 99%

Dietary salt in liver cirrhosis: With a pinch of salt!

Kumar,

Marrapu

2023

World J Hepatol

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Patients with liver cirrhosis are advised to limit their sodium consumption to control excessive fluid accumulation. Salt is the most common form in which sodium is consumed daily. Consequently, various recommendations urge patients to limit salt intake. However, there is a lack of consistency regarding salt restriction across the guidelines. Moreover, there is conflicting evidence regarding the efficacy of salt restriction in the treatment of ascites. Numerous studies have shown that there is no difference in ascites control between patients with restriction of salt intake and those without restriction. Moreover, patients with cirrhosis may have several negative effects from consuming too little salt, although there are no recommendations on the lower limit of salt intake. Sodium is necessary to maintain the extracellular fluid volume; hence, excessive salt restriction can result in volume contraction, which could negatively impact kidney function in a cirrhotic patient. Salt restriction in cirrhotic patients can also compromise nutrient intake, which can have a negative impact on the overall outcome. There is insufficient evidence to recommend restricted salt intake for all patients with cirrhosis, including those with severe hyponatremia. The existing guidelines on salt restriction do not consider the salt sensitivity of patients; their nutritional state, volume status and sodium storage sites; and the risk of hypochloremia. This opinion article aims to critically analyze the existing literature with regard to salt recommendations for patients with liver cirrhosis and identify potential knowledge gaps that call for further research.

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Sarcopenia in Chronic Liver Disease: A Metabolic Perspective

Cited by 13 publications

References 122 publications

β‑carotene attenuates muscle wasting in cancer cachexia by regulating myogenesis and muscle atrophy

β‑carotene attenuates muscle wasting in cancer cachexia by regulating myogenesis and muscle atrophy

Impact of Sarcopenia on Non-Alcoholic Fatty Liver Disease

Dietary salt in liver cirrhosis: With a pinch of salt!

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