Sarcopenic Obesity in Liver Cirrhosis: Possible Mechanism and Clinical Impact

Overview

Journal Int J Mol Sci

Publisher MDPI

Specialties Biochemistry
Chemistry
Molecular Biology

Date 2021 Mar 6

PMID 33671926

Citations 19

Authors

Hiroki Nishikawa

Hirayuki Enomoto

Shuhei Nishiguchi

Hiroko Iijima

Affiliations

Soon will be listed here.

Abstract

The picture of chronic liver diseases (CLDs) has changed considerably in recent years. One of them is the increase of non-alcoholic fatty liver disease. More and more CLD patients, even those with liver cirrhosis (LC), tend to be presenting with obesity these days. The annual rate of muscle loss increases with worsening liver reserve, and thus LC patients are more likely to complicate with sarcopenia. LC is also characterized by protein-energy malnutrition (PEM). Since the PEM in LC can be invariable, the patients probably present with sarcopenic obesity (Sa-O), which involves both sarcopenia and obesity. Currently, there is no mention of Sa-O in the guidelines; however, the rapidly increasing prevalence and poorer clinical consequences of Sa-O are recognized as an important public health problem, and the diagnostic value of Sa-O is expected to increase in the future. Sa-O involves a complex interplay of physiological mechanisms, including increased inflammatory cytokines, oxidative stress, insulin resistance, hormonal disorders, and decline of physical activity. The pathogenesis of Sa-O in LC is diverse, with a lot of perturbations in the muscle-liver-adipose tissue axis. Here, we overview the current knowledge of Sa-O, especially focusing on LC.

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References

Duarte-Rojo A, Ruiz-Margain A, Montano-Loza A, Macias-Rodriguez R, Ferrando A, Kim W . Exercise and physical activity for patients with end-stage liver disease: Improving functional status and sarcopenia while on the transplant waiting list. Liver Transpl. 2017; 24(1):122-139. DOI: 10.1002/lt.24958. View

Inoue T, Nakayama J, Moriya K, Kawaratani H, Momoda R, Ito K . Gut Dysbiosis Associated With Hepatitis C Virus Infection. Clin Infect Dis. 2018; 67(6):869-877. DOI: 10.1093/cid/ciy205. View

Shabkhiz F, Khalafi M, Rosenkranz S, Karimi P, Moghadami K . Resistance training attenuates circulating FGF-21 and myostatin and improves insulin resistance in elderly men with and without type 2 diabetes mellitus: A randomised controlled clinical trial. Eur J Sport Sci. 2020; 21(4):636-645. DOI: 10.1080/17461391.2020.1762755. View

Zenith L, Meena N, Ramadi A, Yavari M, Harvey A, Carbonneau M . Eight weeks of exercise training increases aerobic capacity and muscle mass and reduces fatigue in patients with cirrhosis. Clin Gastroenterol Hepatol. 2014; 12(11):1920-6.e2. DOI: 10.1016/j.cgh.2014.04.016. View

Nishikawa H, Shiraki M, Hiramatsu A, Moriya K, Hino K, Nishiguchi S . Japan Society of Hepatology guidelines for sarcopenia in liver disease (1st edition): Recommendation from the working group for creation of sarcopenia assessment criteria. Hepatol Res. 2016; 46(10):951-63. DOI: 10.1111/hepr.12774. View

Moriwaki H, Miwa Y, Tajika M, Kato M, Fukushima H, Shiraki M . Branched-chain amino acids as a protein- and energy-source in liver cirrhosis. Biochem Biophys Res Commun. 2003; 313(2):405-9. DOI: 10.1016/j.bbrc.2003.07.016. View

Bhanji R, Moctezuma-Velazquez C, Duarte-Rojo A, Ebadi M, Ghosh S, Rose C . Myosteatosis and sarcopenia are associated with hepatic encephalopathy in patients with cirrhosis. Hepatol Int. 2018; 12(4):377-386. DOI: 10.1007/s12072-018-9875-9. View

Chen L, Woo J, Assantachai P, Auyeung T, Chou M, Iijima K . Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020; 21(3):300-307.e2. DOI: 10.1016/j.jamda.2019.12.012. View

Nishikawa H, Enomoto H, Yoh K, Iwata Y, Sakai Y, Kishino K . Serum Zinc Concentration and Sarcopenia: A Close Linkage in Chronic Liver Diseases. J Clin Med. 2019; 8(3). PMC: 6462961. DOI: 10.3390/jcm8030336. View

10.

Kruger C, McNeely M, Bailey R, Yavari M, Abraldes J, Carbonneau M . Home Exercise Training Improves Exercise Capacity in Cirrhosis Patients: Role of Exercise Adherence. Sci Rep. 2018; 8(1):99. PMC: 5758716. DOI: 10.1038/s41598-017-18320-y. View

11.

Albano D, Messina C, Vitale J, Sconfienza L . Imaging of sarcopenia: old evidence and new insights. Eur Radiol. 2019; 30(4):2199-2208. DOI: 10.1007/s00330-019-06573-2. View

12.

Sinclair M, Grossmann M, Hoermann R, Angus P, Gow P . Testosterone therapy increases muscle mass in men with cirrhosis and low testosterone: A randomised controlled trial. J Hepatol. 2016; 65(5):906-913. DOI: 10.1016/j.jhep.2016.06.007. View

13.

Kumar A, Davuluri G, Nascimento E Silva R, Engelen M, Ten Have G, Prayson R . Ammonia lowering reverses sarcopenia of cirrhosis by restoring skeletal muscle proteostasis. Hepatology. 2017; 65(6):2045-2058. PMC: 5444955. DOI: 10.1002/hep.29107. View

14.

Kim T, Choi K . The implications of sarcopenia and sarcopenic obesity on cardiometabolic disease. J Cell Biochem. 2014; 116(7):1171-8. DOI: 10.1002/jcb.25077. View

15.

Sakamaki A, Yokoyama K, Koyama K, Morita S, Abe H, Kamimura K . Obesity and accumulation of subcutaneous adipose tissue are poor prognostic factors in patients with alcoholic liver cirrhosis. PLoS One. 2020; 15(11):e0242582. PMC: 7671528. DOI: 10.1371/journal.pone.0242582. View

16.

Bloemen J, Olde Damink S, Venema K, Buurman W, Jalan R, Dejong C . Short chain fatty acids exchange: Is the cirrhotic, dysfunctional liver still able to clear them?. Clin Nutr. 2009; 29(3):365-9. DOI: 10.1016/j.clnu.2009.10.002. View

17.

Kawaguchi T, Izumi N, Charlton M, Sata M . Branched-chain amino acids as pharmacological nutrients in chronic liver disease. Hepatology. 2011; 54(3):1063-70. DOI: 10.1002/hep.24412. View

18.

Park P, Sanz-Garcia C, Nagy L . Adiponectin as an anti-fibrotic and anti-inflammatory adipokine in the liver. Curr Pathobiol Rep. 2016; 3(4):243-252. PMC: 4743902. DOI: 10.1007/s40139-015-0094-y. View

19.

Qin N, Yang F, Li A, Prifti E, Chen Y, Shao L . Alterations of the human gut microbiome in liver cirrhosis. Nature. 2014; 513(7516):59-64. DOI: 10.1038/nature13568. View

20.

Muto Y, Sato S, Watanabe A, Moriwaki H, Suzuki K, Kato A . Overweight and obesity increase the risk for liver cancer in patients with liver cirrhosis and long-term oral supplementation with branched-chain amino acid granules inhibits liver carcinogenesis in heavier patients with liver cirrhosis. Hepatol Res. 2006; 35(3):204-14. DOI: 10.1016/j.hepres.2006.04.007. View