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Sarcopenic obesity in fatty liver

Merli, Manuela; Lattanzi, Barbara; Aprile, Francesca

Current Opinion in Clinical Nutrition & Metabolic Care: May 2019 - Volume 22 - Issue 3 - p 185–190
doi: 10.1097/MCO.0000000000000558
TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Claude Pichard and Mariëlle P.K.J. Engelen

Purpose of review Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steato hepatitis have an increasing prevalence among liver diseases. Overweight and obesity are frequently associated conditions in patients with fatty liver. Skeletal muscle mass depletion may also coexist with chronic liver disease even in obese patients. This review will focus on the relationship between sarcopenic obesity and fatty liver.

Recent findings Obesity and sarcopenia are frequently encountered in patients with NAFLD. Adipose tissue is able to release molecules (adipokines) that regulate lipid metabolism, interact with insulin sensitivity and may contribute to induce fibrogenesis in the liver. Skeletal muscle tissue is able to secrete myokines regulating muscle metabolism and insulin sensitivity. Myokines perturbation has been reported to influence adipose tissue mass and fat deposition in the liver. Sarcopenia has been reported as independent risk factor for the development of NAFLD, and for a more severe liver fibrosis in patients with NAFLD.

Summary The interaction between skeletal muscle, adipose tissue and the liver may play a role in the development of NAFLD. Sarcopenia and sarcopenic obesity are risk factors for the development of fatty liver and associated with more severe liver fibrosis. Management is not standardized, but dietary counseling and physical training have been proposed as promising strategies. Bariatric surgery may be considered in patients with severe ‘resistant’ obesity.

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

Correspondence to Manuela Merli, Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell’Università 37, Rome, Italy. E-mail:

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