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World J Gastroenterol. Mar 14, 2017; 23(10): 1747-1757
Published online Mar 14, 2017. doi: 10.3748/wjg.v23.i10.1747
Non-alcoholic fatty liver disease connections with fat-free tissues: A focus on bone and skeletal muscle
Eleonora Poggiogalle, Lorenzo Maria Donini, Andrea Lenzi, Claudio Chiesa, Lucia Pacifico
Eleonora Poggiogalle, Lorenzo Maria Donini, Andrea Lenzi, Department of Experimental Medicine- Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, 00185 Rome, Italy
Claudio Chiesa, Institute of Translational Pharmacology, National Research Council, 00133 Rome, Italy
Lucia Pacifico, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
Author contributions: Poggiogalle E, Donini LM, Lenzi A, Chiesa C and Pacifico L designed the study, analyzed the data and wrote the manuscript; all authors participated in the critical review and in the final approval of the manuscript.
Conflict-of-interest statement: There are no potential conflicts of interest relevant to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lucia Pacifico, MD, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Viale Regina Elena, 324, 00161 Rome, Italy. lucia.pacifico@uniroma1.it
Telephone: +39-6-49979215 Fax: +39-6-49979216
Received: October 28, 2016
Peer-review started: November 22, 2016
First decision: January 19, 2017
Revised: January 30, 2017
Accepted: February 16, 2017
Article in press: February 17, 2017
Published online: March 14, 2017
Processing time: 136 Days and 4.7 Hours
Abstract

The estimates of global incidence and prevalence of non-alcoholic fatty liver disease (NAFLD) are worrisome, due to the parallel burden of obesity and its metabolic complications. Indeed, excess adiposity and insulin resistance represent two of the major risk factors for NAFLD; interestingly, in the last years a growing body of evidence tended to support a novel mechanistic perspective, in which the liver is at the center of a complex interplay involving organs and systems, other than adipose tissue and glucose homeostasis. Bone and the skeletal muscle are fat- free tissues which appeared to be independently associated with NAFLD in several cross-sectional studies. The deterioration of bone mineral density and lean body mass, leading to osteoporosis and sarcopenia, respectively, are age-related processes. The prevalence of NAFLD also increases with age. Beyond physiological aging, the three conditions share some common underlying mechanisms, and their elucidations could be of paramount importance to design more effective treatment strategies for the management of NAFLD. In this review, we provide an overview on epidemiological data as well as on potential contributors to the connections of NAFLD with bone and skeletal muscle.

Keywords: Non-alcoholic fatty liver disease; Bone; Skeletal muscle; Osteoporosis; Sarcopenia

Core tip: Novel epidemiological findings open new avenues for a thorough understanding of the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Liver appears to participate in a fascinating cross- talk with fat-free tissue, mainly bone and skeletal muscle. The identification of contributors other than the classic roles played by excess fat and insulin resistance may be relevant for the design of more effective treatment strategies for NAFLD.