Viswanath A, Fouda S, Fernandez CJ, Pappachan JM. Metabolic-associated fatty liver disease and sarcopenia: A double whammy. World J Hepatol 2024; 16(2): 152-163 [PMID: 38495287 DOI: 10.4254/wjh.v16.i2.152]
Corresponding Author of This Article
Joseph M Pappachan, FRCP, MD, Academic Editor, Consultant Endocrinologist, Professor, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Sharoe Green Lane, Preston PR2 9HT, United Kingdom. drpappachan@yahoo.co.in
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Review
Open-Access Policy of This Article
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/
World J Hepatol. Feb 27, 2024; 16(2): 152-163 Published online Feb 27, 2024. doi: 10.4254/wjh.v16.i2.152
Metabolic-associated fatty liver disease and sarcopenia: A double whammy
Aditya Viswanath, Sherouk Fouda, Cornelius James Fernandez, Joseph M Pappachan
Aditya Viswanath, School of Medicine, Leicester University, Leicester LE1 7RH, United Kingdom
Sherouk Fouda, School of Health and Biomedical Sciences, Rmit University, Melbourne VIC, Australia
Cornelius James Fernandez, Department of Endocrinology and Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston PE21 9QS, United Kingdom
Joseph M Pappachan, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
Joseph M Pappachan, Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
Joseph M Pappachan, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
Author contributions: Viswanath A performed initial literature search, interpretation of relevant literature, article drafting, revision and figure preparation and is the first author of the work; Fouda S substantially contributed to the conception of the work with additional literature review and revision of the article critically for important intellectual content; Fernandez CJ and Pappachan JM contributed to the conceptual design of the paper and critically supervised the whole drafting, revision and modifications of the paper including figure construction and share final authorship; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joseph M Pappachan, FRCP, MD, Academic Editor, Consultant Endocrinologist, Professor, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Sharoe Green Lane, Preston PR2 9HT, United Kingdom. drpappachan@yahoo.co.in
Received: December 6, 2023 Peer-review started: December 6, 2023 First decision: December 18, 2023 Revised: December 26, 2023 Accepted: January 17, 2024 Article in press: January 17, 2024 Published online: February 27, 2024
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.
Core Tip: Metabolic-associated fatty liver disease (MAFLD) is associated with sarcopenia in a significant proportion of individuals. Sarcopenia can be a consequence of the comorbidities associated with MAFLD (such as obesity or adiposity) or a direct result of advanced stages of MAFLD, such as fibrosis and cirrhosis. On the other hand, sarcopenia can worsen MAFLD due to reduced exercise capacity and the release of various myokines. Understanding the strong interlink between MAFLD and sarcopenia is important to plan appropriate therapeutic strategies. We discuss the pathobiological aspects of this interlink and the potential clinical and metabolic complications of the coexistence of MAFLD and sarcopenia in this comprehensive clinical update review.
