Highlights
- •NAFLD is seen in individuals with obesity and insulin resistance, which are closely associated with sarcopenia.
- •As the prevalence of obesity continues to grow, NAFLD and sarcopenia are projected to increase in the near future.
- •Studies suggested that sarcopenia is associated with the increased risk of NAFLD and fibrosis.
- •Resistance physical activity may be considered for therapeutic strategies for subjects with both sarcopenia and NAFLD.
- •This review summarized the impact of sarcopenia and obesity on NAFLD, especially in the elderly population.
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver
disease in children and adults of all ethnicities. NAFLD is commonly seen in individuals
with metabolic abnormalities, such as obesity and insulin resistance, which are closely
associated with sarcopenia. Sarcopenia, defined as low muscle mass and impaired muscle
function, is associated with NAFLD and worse outcomes in patients with NAFLD. As the
world’s elderly population and the prevalence of obesity continues to grow at an unprecedented
rate, NAFLD and sarcopenia are projected to increase. Given that there are no approved
pharmacologic treatments for NAFLD, it is imperative to gain a better understanding
of the disease pathophysiology, to guide treatment options. Recent studies have given
new insight into sarcopenic obesity, but there is no consensus on its definition.
In this review, we attempt to address the impact of sarcopenia and obesity on NAFLD,
especially in the elderly population.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes.Hepatology. 2016; 64: 73-84
- Sarcopenia: European consensus on definition and diagnosis: report of the European working group on Sarcopenia in older people.Age Ageing. 2010; 39: 412-423
- Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study.Lancet Oncol. 2008; 9: 629-635
- World’s Older Population Grows Dramatically NIH-funded Census Bureau Report Offers Details of Global Aging Phenomenon.2016
- Non-alcoholic fatty liver disease in older people.Gerontology. 2009; 55: 607-613
- Non-alcoholic fatty liver disease—a common and benign finding in octogenarian patients.Liver Int. 2004; 24: 588-594
- Prevalence and associated metabolic factors of fatty liver disease in the elderly.Exp. Gerontol. 2013; 48: 705-709
- Features, diagnosis, and treatment of nonalcoholic fatty liver disease.Clin. Gastroenterol. Hepatol. 2012; 10: 837-858
- The relation between non-alcoholic fatty liver disease and the risk of coronary heart disease in Koreans.Am. J. Gastroenterol. 2009; 104: 1953-1960
- Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults.J. Gastroenterol. Hepatol. 2006; 21: 138-143
- Nonalcoholic fatty liver disease.Gastroenterology. 2002; 122: 1649-1657
- Gender and menopause impact severity of fibrosis among patients with nonalcoholic steatohepatitis.Hepatology. 2014; 59: 1406-1414
- The protective effects of estrogen on the cardiovascular system.N. Engl. J. Med. 1999; 340: 1801-1811
- Estrogen: a master regulator of bioenergetic systems in the brain and body.Front. Neuroendocrinol. 2014; 35: 8-30
- Impact of oestrogens on the progression of liver disease.Liver Int. 2003; 23: 63-69
- Incidence and risk factors for non-alcoholic steatohepatitis: prospective study of 5408 women enrolled in Italian tamoxifen chemoprevention trial.Bmj. 2005; 330: 932
- Oral contraceptive pill use is associated with reduced odds of nonalcoholic fatty liver disease in menstruating women: results from NHANES III.J. Gastroenterol. 2013; 48: 1151-1159
- Serum testosterone and non-alcoholic fatty liver disease in men and women in the US.Liver Int. 2018; 38: 2051-2059
- Sarcopenia: European consensus on definition and diagnosis: report of the European working group on Sarcopenia in older people.Age Ageing. 2010; 39: 412-423
- Techniques for the diagnosis of sarcopenia.Clin. Cases Miner. Bone Metab. 2014; 11: 181-184
- Hand-grip Strength as a predictor of muscular strength and endurance.J. Strength Cond. Res. 2011; 25: S99
- Sarcopenia in Asia: consensus report of the asian working group for Sarcopenia.J. Am. Med. Dir. Assoc. 2014; 15: 95-101
- The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates.J. Gerontol. A Biol. Sci. Med. Sci. 2014; 69: 547-558
- Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia.J. Am. Med. Dir. Assoc. 2011; 12: 249-256
- Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.Lancet. 2004; 363: 157-163
- Body composition in healthy aging.Ann. N. Y. Acad. Sci. 2000; 904: 437-448
- Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review.Front. Physiol. 2012; 3: 260
- Age related shift in visceral fat.Int. J. Body Compos. Res. 2010; 8: 103-108
- Sarcopenic obesity and overall mortality: Results from the application of novel models of body composition phenotypes to the National Health and Nutrition Examination Survey 1999–2004.Clin. Nutr. 2018;
- Association between sarcopenic obesity and cardiovascular risk: where are we?.Nutr. Hosp. 2016; 33: 592
- Variation in the prevalence of sarcopenia and sarcopenic obesity in older adults associated with different research definitions: dual-energy X-ray absorptiometry data from the National Health and Nutrition Examination Survey 1999-2004.J. Am. Geriatr. Soc. 2013; 61: 974-980
- Prevalence of sarcopenia and sarcopenic obesity in the Korean population based on the Fourth Korean National Health and Nutritional Examination Surveys.J. Gerontol. A Biol. Sci. Med. Sci. 2012; 67: 1107-1113
- Sarcopenia, sarcopenic obesity and inflammation: results from the 1999-2004 National Health and Nutrition Examination Survey.Clin. Nutr. 2016; 35: 1472-1483
- Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies.Nat. Rev. Endocrinol. 2018; 14: 513-537
- Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey.J. Clin. Endocrinol. Metab. 2011; 96: 2898-2903
- Relationship between sarcopenia and nonalcoholic fatty liver disease: the Korean Sarcopenic Obesity Study.Hepatology. 2014; 59: 1772-1778
- Sarcopaenia is associated with NAFLD independently of obesity and insulin resistance: nationwide surveys (KNHANES 2008–2011).J. Hepatol. 2015; 63: 486-493
- Sarcopenia is associated with significant liver fibrosis independently of obesity and insulin resistance in nonalcoholic fatty liver disease: nationwide surveys (KNHANES 2008–2011).Hepatology. 2016; 63: 776-786
- Associations between sarcopenia and nonalcoholic fatty liver disease and advanced fibrosis in the USA.Eur J Gastroenterol Hepatol. 2019;
- Sarcopenia and risk of nonalcoholic fatty liver disease: a meta-analysis.Saudi J. Gastroenterol. 2018; 24: 12-17
- Relationship between relative skeletal muscle mass and nonalcoholic fatty liver disease: a 7-Year longitudinal study.Hepatology. 2018; 68: 1755-1768
- Age-related decrease in skeletal muscle mass is an independent risk factor for incident nonalcoholic fatty liver disease: a 10-Year retrospective cohort study.Gut Liver. 2019; 13: 67-76
- Sarcopenia is an independent risk factor for non-alcoholic steatohepatitis and significant fibrosis.J. Hepatol. 2017; 66: 123-131
- Sarcopenia is associated with severe liver fibrosis in patients with non-alcoholic fatty liver disease.Aliment. Pharmacol. Ther. 2017; 45: 510-518
- Liver fibrosis, but No other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease.Gastroenterology. 2015; 149 (e10): 389-397
- Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States.Hepatology. 2013; 57: 1357-1365
- The relationship between NAFLD and Sarcopenia in elderly patients.Can. J. Gastroenterol. Hepatol. 2018; 20185016091
- Mechanisms of obesity-induced inflammation and insulin resistance: insights into the emerging role of nutritional strategies.Front. Endocrinol. (Lausanne). 2013; 4: 52
- Sources of fatty acids stored in liver and secreted via lipoproteins in patients with nonalcoholic fatty liver disease.J. Clin. Invest. 2005; 115: 1343-1351
- Inhibition of ceramide de novo synthesis reduces liver lipid accumulation in rats with nonalcoholic fatty liver disease.Liver Int. 2014; 34: 1074-1083
- Serum vitamin D, intact parathyroid hormone, and Fetuin A concentrations were associated with geriatric sarcopenia and cardiac hypertrophy.Sci. Rep. 2017; 7: 40996
- Muscle ectopic fat deposition contributes to anabolic resistance in obese sarcopenic old rats through eIF2alpha activation.Aging Cell. 2014; 13: 1001-1011
- Nonalcoholic steatohepatitis is strongly associated with sarcopenic obesity in patients with cirrhosis undergoing liver transplant evaluation.J. Gastroenterol. Hepatol. 2016; 31: 628-633
- Sarcopenic obesity.Hormones. 2018; 17: 321-331
- Fatty liver index associates with relative Sarcopenia and GH/ IGF- 1 status in obese subjects.PLoS One. 2016; 11e0145811
- Diet-induced nonalcoholic fatty liver disease is associated with sarcopenia and decreased serum insulin-like growth factor-1.Dig. Dis. Sci. 2016; 61: 3190-3198
- Growth hormone inhibits hepatic de novo lipogenesis in adult mice.Diabetes. 2015; 64: 3093-3103
- Somatotropic Axis dysfunction in non-alcoholic fatty liver disease: beneficial hepatic and systemic effects of hormone supplementation.Int. J. Mol. Sci. 2018; 19
- Relationship between sarcopenic obesity-related phenotypes and inflammatory markers in postmenopausal women.Clin. Physiol. Funct. Imaging. 2017; 37: 205-210
- Association of sarcopenic obesity with higher serum high-sensitivity C-Reactive protein levels in chinese older males—A community-based study (Taichung community health study-elderly, TCHS-E).PLoS One. 2015; 10e0132908
- Large-scale isolation of human skeletal muscle satellite cells from post-mortem tissue and development of quantitative assays to evaluate modulators of myogenesis.J. Cachexia Sarcopenia Muscle. 2013; 4: 157-169
- Triglycerides potentiate the inflammatory response in rat Kupffer cells.Antioxid. Redox Signal. 2008; 10: 2009-2022
- Dysbiosis gut microbiota associated with inflammation and impaired mucosal immune function in intestine of humans with non-alcoholic fatty liver disease.Sci. Rep. 2015; 5: 8096
- Circulating irisin levels as a predictive biomarker for sarcopenia: a cross-sectional community-based study.Geriatr. Gerontol. Int. 2017; 17: 2266-2273
- Serum markers of inflammation and oxidative stress in sarcopenia.Aging Clin. Exp. Res. 2017; 29: 745-752
- Hypoadiponectinemia and its association with liver fibrosis in morbidly obese patients.Obes. Surg. 2010; 20: 1400-1407
- Circulating leptin in non-alcoholic fatty liver disease: a systematic review and meta-analysis.Diabetologia. 2016; 59: 30-43
- Fetuin A in nonalcoholic fatty liver disease: in vivo and in vitro studies.Eur. J. Endocrinol. 2012; 166: 503-510
- Cross-sectional associations of objectively measured physical activity and sedentary time with sarcopenia and sarcopenic obesity in older men.Prev. Med. 2016; 91: 264-272
- Effects of aerobic and resistance exercise on metabolic syndrome, sarcopenic obesity, and circulating biomarkers in overweight or obese survivors of breast cancer: a randomized controlled trial.J. Clin. Oncol. 2018; 36: 875-883
- Effects of different types of exercise on body composition, muscle strength, and IGF-1 in the elderly with sarcopenic obesity.J. Am. Geriatr. Soc. 2017; 65: 827-832
- Caloric restriction and aerobic exercise in sarcopenic and non-sarcopenic obese women: an observational and retrospective study.J. Cachexia Sarcopenia Muscle. 2016; 7: 284-289
- Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial.J. Am. Med. Dir. Assoc. 2015; 16: 740-747
- Omega-3 fatty acid EPA improves regenerative capacity of mouse skeletal muscle cells exposed to saturated fat and inflammation.Biogerontology. 2017; 18: 109-129
- Effect of exercise alone or combined with dietary supplements on anthropometric and physical performance measures in community-dwelling elderly people with sarcopenic obesity: A meta-analysis of randomized controlled trials.Maturitas. 2018; 116: 24-35
- Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis.Gastroenterology. 2015; 149 (e5; quiz e14-5): 367-378
- Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women.Int. J. Obes. Relat. Metab. Disord. 2004; 28: 234-241
- Sarcopenic obesity and inflammation in the InCHIANTI study.J. Appl. Physiol. 1985; 102 (2007): 919-925
- Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study.Int. J. Obes. (Lond). 2009; 33: 885-892
- Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA).Diabetes Care. 2010; 33: 1652-1654
- The impact of insulin resistance and inflammation on the association between sarcopenic obesity and physical functioning.Obesity (Silver Spring). 2012; 20: 2101-2106
- Sarcopenia and sarcopenic obesity among men aged 80 years and older in Beijing: prevalence and its association with functional performance.Geriatr. Gerontol. Int. 2014; 14: 29-35
Article info
Publication history
Published online: March 25, 2019
Accepted:
March 24,
2019
Received in revised form:
March 19,
2019
Received:
February 19,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
