Impact of Sarcopenia on Non-Alcoholic Fatty Liver Disease - PubMed (original) (raw)

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Impact of Sarcopenia on Non-Alcoholic Fatty Liver Disease

Michihiro Iwaki et al. Nutrients. 2023.

Abstract

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.

Keywords: non-alcoholic fatty liver disease 1; non-alcoholic steatohepatitis 3; sarcopenia 2; sarcopenia-associated obesity 4.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

Figure 1

FFA, free fatty acid; FGF21, fibroblast growth factor 21; GF, growth factor; IGF-1, insulin-like growth factor: mTORC1, mechanistic/mammalian target of rapamycin complex 1; SREBP1c, Sterol regulatory element binding protein-1c. Upward arrows indicate enhancement and downward arrows indicate inhibition.

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