Features of Management of Patients with NAFLD and Sarcopenia

Nowadays non-alcoholic fatty liver disease (NAFLD) and sarcopenia are actually considered as one of the pathological condition with involvement into development of pathology of liver and skeletal muscles. Scientists of different countries found that sarcopenia is associated with insulin resistance and skeletal muscle atrophy as an insulin target organ. Spredly known many cytokines of inflammation with variable affection of skeletal muscle proteins, low level of adiponectin, decreased insulin sensitivity, oxidative stress with activation of catabolism leading to muscle atrophy are involved into complicated pathogenesis of NAFLD. Progressive sarcopenia associated with NAFLD is prognostic factor and can increase the risk of mortality. Sarcopenia, which due to decreased skeletal muscle mass and increased visceral fat, very often provokes development of sarcopenic obesity and NAFLD. Hyperammonemia, abnormal intestinal microbiota, lipid factors also contribute to the development of sarcopenia in patients with NAFLD. Given the common pathogenetic mechanisms indicating a bidirectional relationship between sarcopenia and NAFLD, a multidisciplinary approach to the management of patients with NAFLD and sarcopenia could be the most optimal. Modern strategies are aimed at early diagnosis of NAFLD with sarcopenia, optimizing the lifestyle of these patients, searching for effective drugs, personalizing treatment and prevention of the progression of these diseases and their complications.