Nonalcoholic fatty liver disease and sarcopenia: pathophysiological connections and therapeutic implications

Tiziana Fernández-Mincone, Felipe Contreras-Briceño, Maximiliano Espinosa-Ramírez, Patricio García-Valdés, Antonio López-Fuenzalida, Arnoldo Riquelme, Juan Pablo Arab, Daniel Cabrera, Marco Arrese, Francisco Barrera*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Introduction: Nonalcoholic fatty liver disease (NAFLD) is currently one of the most common liver diseases worldwide. Recent data suggest that loss of skeletal muscle mass and function (i.e. sarcopenia) is highly prevalent and frequently overlooked in NAFLD patients. Experimental and clinical data suggest that the relationship between NAFLD and sarcopenia is pathophysiologically complex and bi-directional and there is a growing interest in unveiling how sarcopenia could influence NAFLD development and progression. Areas covered: PubMed/MEDLINE was searched for articles related to concomitant occurrence of NAFLD and sarcopenia between January 2013 and April 2020. Areas covered in this review include: (1) updated sarcopenia diagnosis strategy, (2) discussion of current data on pathophysiological connections between NAFLD and sarcopenia, and (3) analysis of current and future therapeutic implications of this knowledge. Expert opinion: Clinical studies describe a consistent association between NAFLD and sarcopenia, although a cause–effect relation remains to be determined. Active implementation of current diagnosis algorithms and optimized treatment can prevent sarcopenia related complications in subjects with NAFLD. Pathogenic pathways implicated in this relation are multiple and complex, a better understanding of them can provide novel biomarkers and targeted therapies that will hopefully have an important impact in NAFLD management.

Original languageEnglish
Pages (from-to)1141-1157
Number of pages17
JournalExpert Review of Gastroenterology and Hepatology
Issue number12
StatePublished - Dec 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.


  • nonalcoholic fatty liver disease (NAFLD)
  • pathophysiology
  • sarcopenia
  • skeletal muscle
  • steatohepatitis
  • steatosis


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