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Review
. 2025 Jan 2;17(1):178.
doi: 10.3390/nu17010178.

Sarcopenia in MASLD-Eat to Beat Steatosis, Move to Prove Strength

Dana Crişan  1   2 , Lucreţia Avram  1   2 , Andreea Morariu-Barb  1   3 , Cristiana Grapa  1   3 , Ioana Hirişcau  1 , Rareş Crăciun  1   3 , Valer Donca  1   2 , Andrada Nemeş  1   2
Affiliations
Review

Sarcopenia in MASLD-Eat to Beat Steatosis, Move to Prove Strength

Dana Crişan et al. Nutrients. .

Abstract

The connections between sarcopenia and various chronic conditions, including type 2 diabetes (T2DM), metabolic syndrome (MetS), and liver disease have been highlighted recently. There is also a high occurrence of sarcopenia in metabolic dysfunction-associated steatotic liver disease (MASLD) patients, who are often disregarded. Both experimental and clinical findings suggest a complex, bidirectional relationship between MASLD and sarcopenia. While vitamin D, testosterone, and specific drug therapies show promise in mitigating sarcopenia, consensus on effective treatments is lacking. Recent focus on lifestyle interventions emphasizes dietary therapy and exercise for sarcopenic obesity in MASLD. Challenges arise as weight loss, a primary MASLD treatment, may lead to muscle mass reduction. The therapeutic approach to sarcopenia in morbidly obese MASLD patients also includes bariatric surgery (BS). BS induces weight loss and stabilizes metabolic imbalances, but its impact on sarcopenia is nuanced, underscoring the need for further research. Our aim is to provide a comprehensive review of the interplay between sarcopenia and MASLD and offer insight into the most recent therapeutic challenges and discoveries, as sarcopenia is often overlooked or unrecognized and poses significant challenges for managing these patients.

Keywords: MASLD; metabolic syndrome; sarcopenia; sarcopenic obesity; type 2 diabetes.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The main risk factors for obesity, MASLD, and sarcopenia.
Figure 2
Figure 2
Pathophysiology of the obesity-MASLD-sarcopenia axis.
Figure 3
Figure 3
Summary of MASLD-related sarcopenia treatment.
See this image and copyright information in PMC

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