Laboratory of Experimental Medicine and Paediatrics (LEMP), University of Antwerp, Wilrijk (Antwerp), Belgium.
Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem (Antwerp), Belgium.
Obes Rev. 2019 Feb;20(2):353-363. doi: 10.1111/obr.12776. Epub 2018 Nov 25.
Sarcopenia, described as the loss of muscle mass and/or strength, is gaining importance as it can be increasingly related to many chronic diseases. It is also associated with chronic liver disease, and recently it has been more frequently linked to non-alcoholic fatty liver disease (NAFLD) in particular. Both sarcopenia and NAFLD are subject to complex and intermingled pathophysiological processes, of which some are in common. Furthermore, it is presently unclear if sarcopenia directly contributes to NAFLD or vice versa. The mechanisms that are involved may include obesity, insulin resistance, vitamin D deficiency, aging, physical inactivity and certain cytokines. Current clinical evidence is subject to an important heterogeneity in methods and definitions, with additionally also a relative overrepresentation of evidence in Asian ethnicities. Nonetheless, all studies so far point towards the same association between sarcopenia and NAFLD, including an association with NAFLD-severity and NAFLD-related fibrosis. Since the field is in its infancy, clear definitions and further research are needed to aid to improve understanding of the association between NAFLD and sarcopenia. This can eventually lead to additional potential therapeutic interventions. This review attempts to give an overview of the current published literature that links sarcopenia to NAFLD, followed by a discussion of the presumably involved pathophysiological factors, and ends by discussing current unmet needs.
肌肉减少症，描述为肌肉质量和/或力量的丧失，由于其与许多慢性疾病的关系日益密切而变得越来越重要。它也与慢性肝病有关，最近它与非酒精性脂肪性肝病（NAFLD）的联系更为频繁。肌肉减少症和非酒精性脂肪性肝病都受到复杂且相互交织的病理生理过程的影响，其中一些是共同的。此外，目前尚不清楚肌肉减少症是否直接导致非酒精性脂肪性肝病，反之亦然。可能涉及的机制包括肥胖、胰岛素抵抗、维生素 D 缺乏、衰老、身体活动不足和某些细胞因子。目前的临床证据在方法和定义方面存在重要的异质性，此外，亚洲种族的证据也相对较多。尽管如此，迄今为止所有研究都表明肌肉减少症与非酒精性脂肪性肝病之间存在相同的关联，包括与非酒精性脂肪性肝病严重程度和非酒精性脂肪性肝病相关纤维化的关联。由于该领域还处于起步阶段，因此需要明确的定义和进一步的研究来帮助更好地理解非酒精性脂肪性肝病和肌肉减少症之间的关联。这最终可能会导致更多潜在的治疗干预措施。这篇综述试图概述目前将肌肉减少症与非酒精性脂肪性肝病联系起来的已发表文献，接着讨论可能涉及的病理生理因素，最后讨论当前未满足的需求。
