Pegah Golabi, Lynn Gerber, James M Paik, Rati Deshpande, Leyla de Avila, Zobair M Younossi

JHEP Rep 2020*
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Published August 15, 2020 review by Gérard Bozet, MD

Physical inactivity and sedentary lifestyle have contributed to the epidemic of obesity and non-alcoholic fatty liver disease (NAFLD). Moreover, NAFLD and sarcopenia have similar pathophysiological profiles. Z M Younossi et al. assessed the association between physical activity, NAFLD, and sarcopenia, and their contributions to mortality, using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 together with the Linked Mortality File (LMF); mortality follow-up data updated through December 31, 2015.

Of the 4,611 NHANES participants, NAFLD was present in 29.3%, of whom 17.7% had sarcopenia. Of the NAFLD group, 46.3% were inactive. Sarcopenia was significantly and inversely related to higher physical activity level, both amongst NAFLD and non-NAFLD.

During a median follow-up of 13.5 years, amongst those who died with NAFLD, 33.0% had sarcopenia and 54.3% were inactive. Compared with NAFLD without sarcopenia, NAFLD with sarcopenia was associated with a higher risk of all-cause (HR = 1.78), cardiac-specific (HR = 3.19), and cancer-specific mortality (HR = 2.12).

Sarcopenia should be a part of the clinical assessment of patients with NAFLD. The treatment of NAFLD should include optimal management of sarcopenia.

* JHEP Reports is an open access companion title to the Journal of Hepatology published by EASL, The European Association for the Study of the Liver.

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