Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 27, 2022; 14(8): 1643-1651
Published online Aug 27, 2022. doi: 10.4254/wjh.v14.i8.1643
Prevalence of sarcopenia using different methods in patients with non-alcoholic fatty liver disease
Naiade Silveira Almeida, Raquel Rocha, Claudineia Almeida de Souza, Ana Carolina Sirelli da Cruz, Bruna dos Reis Ribeiro, Luiza Valois Vieira, Carla Daltro, Rafael Silva, Manoel Sarno, Helma Pinchemel Cotrim
Naiade Silveira Almeida, Claudineia Almeida de Souza, Carla Daltro, Rafael Silva, Manoel Sarno, Helma Pinchemel Cotrim, Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
Raquel Rocha, Ana Carolina Sirelli da Cruz, Bruna dos Reis Ribeiro, Luiza Valois Vieira, Carla Daltro, Departamento de Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
Rafael Silva, Manoel Sarno, Caliper Clínica e Escola de Imagem, Salvador 41810-012, Brazil
Author contributions: Almeida NS, da Cruz ACS, de Souza CA, Rocha R, Ribeiro BR participation in the literature review, analysis and interpretation of data, and final writing of the manuscript; Daltro C, Cotrim HP, data analysis and interpretation, literature review and analysis, and final writing of the manuscript; Vieira LV, Silva R, Sarno M data collection; all authors provided critical contributions and approved the manuscript.
Institutional review board statement: This study was reviewed and approved by the Research Ethics Committee of the School of Nutrition of the Federal University of Bahia (Approval No. 2.443.762).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at email address raquelrocha2@yahoo.com.br. Participants gave informed consent for data sharing. No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raquel Rocha, DSc, Adjunct Associate Professor, Ciência da Nutrição, Universidade Federal da Bahia, Rua Araujo Pinho, 32, Salvador 40110-060, Brazil. raquelrocha2@yahoo.com.br
Received: March 17, 2022
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

To evaluate the prevalence of sarcopenia, using different methods, in patients with NAFLD, and its association with the severity of this disease.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

Validation of muscle strength measurement in the early identification of sarcopenia is essential in NAFLD patients.