Emerging Treatment Options for Sarcopenia in Chronic Liver Disease

• Published in: Life (Basel, Switzerland) Vol. 11; no. 3; p. 250
• Main Author: Kim, Yun
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 17.03.2021; MDPI
• Subjects: Activin; Amino acids; Ammonia; Atrophy; Autophagy; Biomarkers; chronic liver disease; cirrhosis; Gene expression; Health services; Homeostasis; Hyperammonemia; Insulin resistance; Insulin-like growth factors; Liver; Liver cirrhosis; Liver diseases; Medical treatment; Mortality; Muscle function; muscle protein turnover; Muscles; Musculoskeletal system; Myostatin; non-alcoholic fatty liver disease; Pathogenesis; Patients; Protein synthesis; Protein turnover; Proteins; Review; Sarcopenia; Signal transduction; Skeletal muscle; Testosterone; Transcription factors; chronic liver disease; muscle protein turnover; non-alcoholic fatty liver disease; cirrhosis; sarcopenia
• ISSN: 2075-1729; 2075-1729
• DOI: 10.3390/life11030250

Sarcopenia is characterized by a skeletal muscle disorder with progressive and generalized loss of muscle mass and function, and it increases the risk of adverse outcomes with considerable prevalence in patients with chronic liver disease. Sarcopenia in chronic liver disease underlies complicated and multifactorial mechanisms for pathogenesis, including alterations in protein turnover, hyperammonemia, energy disposal, hormonal changes, and chronic inflammation. The key contribution to sarcopenia in patients with chronic liver diseases can be the hyperammonemia-induced upregulation of myostatin, which causes muscle atrophy via the expression of atrophy-related genes. Several clinical studies on emerging treatment options for sarcopenia have been reported, but only a few have focused on patients with chronic liver diseases, with mostly nutritional and behavioral interventions being carried out. The inhibition of the myostatin-activin receptor signaling pathway and hormonal therapy might be the most promising therapeutic options in combination with an ammonia-lowering approach in sarcopenic patients with chronic liver diseases. This review focuses on current and emerging treatment options for sarcopenia in chronic liver diseases with underlying mechanisms to counteract this condition.