Sarcopenia Among Patients With Metabolic Dysfunction-associated Steatotic Liver Disease

Inclusion Criteria:

The study is intended to include adult patients with metabolic dysfunction-associated steatotic liver disease which will be diagnosed based on imaging study plus one of the following criteria [8]:

1. BMI ≥ 25 kg/m2 or waist circumference > 94 cm in men, > 80 cm in women
2. Fasting serum glucose ≥ 100 mg/dL (≥ 5.6 mmol/L) or 2-hour post-load glucose level ≥ 140 mg/dL (≥ 7.8 mmol/L) or hemoglobin A1C (HbA1C) ≥ 5.7% or on specific drug treatment
3. Blood pressure ≥ 130/85 mmHg or specific drug treatment
4. Plasma triglycerides ≥ 150 mg/dL (≥ 1.70 mmol/L) or specific drug treatment
5. Plasma high-density lipoprotein (HDL)-cholesterol < 40 mg/dL (< 1.0 mmol/L) for men and < 50 mg/dL (< 1.3 mmol/L) for women or specific drug treatment For significant steatosis grading, hepatic steatosis index (HSI) will be used (BMI, diabetes mellitus, and aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio; cut-off score: >36). [9].

For significant fibrosis staging, both liver stiffness measurement and several fibrosis scores will be used. Fibrosis scores will include NAFLD fibrosis score (BMI, age, hyperglycemia, AST/ALT ratio, albumin, and platelet count; cut-off score: ≥ 0.675) [9].

Exclusion Criteria:

1. Age less than 18 years old or more than 65 years old
2. Pregnant patients
3. Chronic hepatitis C virus and/or hepatitis B virus infection
4. Any alcohol consumption
5. Autoimmune hepatitis
6. Hepatic and/or extrahepatic neoplastic disorders
7. Medication and/or substance use which may lead to hepatic steatosis and/or injury
8. Eating disorders
9. Comorbidities such as neuromuscular, pulmonary, and renal disorders
10. Use of anabolic steroids