Chronic Stress and Steatosis of Muscles, Bones, Liver, and Pancreas: A Review

Horm Res Paediatr. 2023;96(1):66-73. doi: 10.1159/000522540. Epub 2022 Feb 10.

Abstract

Background: Chronic stress is a recognized risk factor for poor health, body composition disequilibrium, impaired mental health, and deterioration of quality of life. Chronic stress-related cortisol oversecretion and circadian dysregulation and associated systemic low grade, injurious inflammation ("para-inflammation") contribute to steatosis in various metabolically active solid organs, affecting both their structure and function. The aim of this review was to summarize current knowledge on the impact of chronic stress and associated para-inflammation on skeletal muscle, bone, liver, and pancreas, leading to their steatosis. Current management of these maladaptive conditions is also included and underscored in this review.

Summary: Steatosis of metabolically active solid organs is involved in various metabolic processes and considered a risk factor for chronic noncommunicable diseases, yet its role in chronic stress physiology and pathophysiology has been overlooked.

Key messages: Chronic stress-associated steatosis of several solid organs is generally disregarded in current clinical practice. Physicians should be alert for these steatoses and should address them adequately so as to provide appropriate medical care. New guidelines generated by learned societies are needed, along with large observational studies, to offer novel solutions to this old problem.

Keywords: Myosteatosis; Nonalcoholic fatty liver disease; Nonalcoholic fatty pancreas disease; Nonalcoholic steatohepatitis; Osteosarcopenic obesity; Stress.

Publication types

  • Review

MeSH terms

  • Fatty Liver*
  • Humans
  • Inflammation / complications
  • Liver
  • Muscle, Skeletal
  • Pancreas
  • Quality of Life*