Molecular Mechanisms and Treatment of Sarcopenia in Liver Disease: A Review of Current Knowledge

Int J Mol Sci. 2021 Jan 31;22(3):1425. doi: 10.3390/ijms22031425.

Abstract

Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength that occurs with aging or in association with various diseases. The condition is prevalent worldwide and occurs more frequently in patients with chronic diseases owing to the intrinsic relationship of muscles with glucose, lipid, and protein metabolism. Liver cirrhosis is characterized by the progression of necro-inflammatory liver diseases, which leads to fibrosis, portal hypertension, and a catabolic state, which causes loss of muscle tissue. Sarcopenia is of significant concern in the state of liver cirrhosis because sarcopenia has been associated with higher mortality, increased hospital admissions, worse post-liver transplant outcomes, decreased quality of life, and increased risk for other complications associated with cirrhosis. Therefore, sarcopenia is also an important feature of liver cirrhosis, representing a negative prognostic factor and influencing mortality. An increased understanding of sarcopenia could lead to the development of novel therapeutic approaches that could help improve the cognitive impairment of cirrhotic patients; therefore, we present a review of the mechanisms and diagnosis of sarcopenia in liver disease and existing therapeutic approaches.

Keywords: BCAA; abnormal sex hormones; hyperammonemia; liver cirrhosis; sarcopenia.

Publication types

  • Review

MeSH terms

  • Humans
  • Hyperammonemia / complications
  • Hyperammonemia / diagnosis
  • Hyperammonemia / therapy
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / therapy
  • Liver Diseases / complications
  • Liver Diseases / diagnosis*
  • Liver Diseases / therapy
  • Liver Transplantation
  • Quality of Life
  • Sarcopenia / complications
  • Sarcopenia / diagnosis*
  • Sarcopenia / genetics
  • Sarcopenia / therapy