Sarcopenia in Chronic Liver Disease: Mechanisms and Countermeasures.

Allen, Sophie Louise, Quinlan, Jonathan I, Dhaliwal, Amritpal, Armstrong, Matthew J, Elsharkawy, Ahmed M, Greig, Carolyn A, Lord, Janet M, Lavery, Gareth G and Breen, Leigh (2020) Sarcopenia in Chronic Liver Disease: Mechanisms and Countermeasures. American journal of physiology. Gastrointestinal and liver physiology. ISSN 1522-1547.

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Sarcopenia, a condition of low muscle mass, quality and strength, is commonly found in cirrhotic patients and is associated with adverse clinical outcomes including: reduction in quality of life, increased mortality and post-transplant complications. In chronic liver disease (CLD) it is most commonly defined through the measurement of the skeletal muscle index of the third lumbar spine. A major contributor to sarcopenia in CLD is the imbalance in muscle protein turnover, which likely occurs due to a decrease in muscle protein synthesis and an elevation in muscle protein breakdown. This imbalance is assumed to arise due to a number of factors including: accelerated starvation, hyperammonemia, amino acid deprivation, chronic inflammation, excessive alcohol intake and physical inactivity. In particular, hyperammonemia is a key mediator of the liver-gut axis and is known to contribute to mitochondrial dysfunction and an increase in myostatin expression. Currently, the use of late-evening snacks, branched-chain amino acid supplementation and physical activity have been proposed to help the management and treatment of sarcopenia. However, little evidence exists to comprehensively support their use in clinical settings. A number of new, pharmacological strategies, including myostatin inhibition and the nutraceutical Urolithin A have recently been proposed to treat age-related sarcopenia, and may also be of use in CLD. This review highlights the potential molecular mechanisms contributing to sarcopenia in CLD alongside a discussion of existing and potential new treatment strategies.

Item Type: Article
Subjects: WI Digestive system. Gastroenterology
Divisions: Planned IP Care > Gastroentrology
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Depositing User: Mrs Caroline Tranter
Date Deposited: 04 Dec 2020 12:15
Last Modified: 04 Dec 2020 12:15

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