The Roles of Non-Pharmacologic and Emerging Pharmacologic Management of Non-alcoholic Fatty Liver Disease and Sarcopenia: A Narrative Review

Frederick Rivera; Arcel Villanueva Adizas; Deanna Cubarrubias; Nathan Ross B.  Bantayan; Sarang Choi; Genquen Philip Carado; Marc Gregory Yu; Edgar Lerma; Krishnaswami Vijayaraghavan

doi:10.15605/jafes.039.01.04

Authors

Frederick Berro Rivera Lincoln Medical Center https://orcid.org/0000-0001-9100-0724
Arcel Villanueva Adizas University of the Philippines Manila https://orcid.org/0009-0006-1912-5876
Deanna Cubarrubias University of the Philippines Manila https://orcid.org/0009-0005-0294-558X
Nathan Ross B. Bantayan University of the Philippines Manila https://orcid.org/0000-0001-9088-8880
Sarang Choi Ateneo de Manila School of Medicine and Public Health https://orcid.org/0009-0003-4852-9405
Genquen Philip Carado Ateneo de Manila School of Medicine and Public Health
Marc Gregory Yu, MD Joslin Diabetes Center and Harvard Medical School https://orcid.org/0000-0002-0376-9574
Edgar Lerma University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA https://orcid.org/0000-0002-0976-5478
Krishnaswami Vijayaraghavan University of Arizona, Phoenix, Arizona, USA https://orcid.org/0000-0002-0919-9736

DOI:

https://doi.org/10.15605/jafes.039.01.04

Keywords:

NAFLD, Sarcopenia, Fatty liver disease

Abstract

Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent causes of chronic liver disease worldwide which is often seen in patients with metabolic abnormalities such as those with obesity and insulin resistance. On the other
hand, sarcopenia is a generalized and progressive skeletal muscle disorder characterized by low muscle strength, low muscle quality, low physical performance, or a combination of the three. Both disease entities share several underlying risk factors and pathophysiologic mechanisms. These include: (1) cardiometabolic overlaps such as insulin resistance, chronic systemic inflammation, decreased vitamin D levels, sex hormone modifications; (2) muscle-related factors such as those mitigated by myostatin signaling, and myokines (i.e., irisin); and (3) liver-dysfunction related factors such as
those associated with growth hormone/insulin-like growth factor 1 Axis, hepatokines (i.e., selenoprotein P and leukocyte cell-derived chemotaxin-2), fibroblast growth factors 21 and 19 (FGF21 and FGF19), and hyperammonemia. This narrative review will examine the pathophysiologic overlaps that can explain the links between NAFLD and sarcopenia. Furthermore, this review will explore the emerging roles of nonpharmacologic (e.g., weight reduction, diet, alcohol, and smoking cessation, and physical activity) and pharmacologic management (e.g., roles of β-hydroxy-β-methylbutyrate, branched-chain amino acid supplements, and testosterone therapy) to improve care, intervention sustainability, and acceptability for patients with sarcopenia-associated NAFLD.

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Author Biography

Edgar Lerma, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA

Section of Nephrology

References

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