Published online Aug 27, 2022. doi: 10.4254/wjh.v14.i8.1643
Peer-review started: March 17, 2022
First decision: April 28, 2022
Revised: May 11, 2022
Accepted: July 26, 2022
Article in press: July 26, 2022
Published online: August 27, 2022
Sarcopenia is a clinical condition possibly associated with Non-Alcoholic Fatty Liver Disease (NAFLD) as they share common pathophysiological mechanisms, such as insulin resistance. The diagnostic criteria available in the literature to define sarcopenia are diverse, and even those established in consensus have been questioned in relation to their diagnostic accuracy.
Previous studies demonstrated an association between sarcopenia and NAFLD. However, the assessment of sarcopenia is performed by various diagnostic methods, which implies discrepant prevalence. The search for the best method led to the two most used consensuses in the scientific community for the diagnosis of sarcopenia in the population and that were not previously investigated in patients with NAFLD.
To evaluate the prevalence of sarcopenia, using different methods, in patients with NAFLD, and its association with the severity of this disease.
Sarcopenia was defined by the European Working Group Consensus on Sarcopenia in Older People of 2010 (EWGSOP1) and 2018 (EWGSOP2). Abdominal ultrasound was used to diagnose hepatic steatosis. The non-invasive fibrosis scores, FIB-4 and APRI, were used to assess the absence and presence of fibrosis.
The diagnosis of sarcopenia was identified only by EWGSOP1, and the EWGSOP2 algorithm identified probable sarcopenia or pre-sarcopenia. Sarcopenia, defined by EWGSOP1, was associated with grade I steatosis, but without excess weight (P < 0.05). EWGSOP2 showed a greater number of patients with probable sarcopenia, overweight, with a greater degree of steatosis and presence of fibrosis compared to EWGSOP1.
Sarcopenia in NAFLD was not predominant in patients without fibrosis, by both consensuses. In addition, the prevalence of probable sarcopenia, a promising early indicator of sarcopenia, was higher by the EWGSOP2 method.
Validation of muscle strength measurement in the early identification of sarcopenia is essential in NAFLD patients.