The following is a summary of “Metabolic associated fatty liver disease and sarcopenia additively increase mortality: a real-world study,” published in the November 2023 issue of Nephrology by Zhao et al.

In this study, the researchers explored the intricate relationship between metabolic-associated fatty liver disease (MAFLD) and sarcopenia concerning their impact on mortality rates and liver fibrosis in a real-world context. Their investigation drew upon a robust dataset comprising 13,692 individuals sourced from the third National Health and Nutrition Examination Surveys, with data linked to mortality records until December. MAFLD diagnosis was established based on radiologically confirmed hepatic steatosis in conjunction with overweight/obesity, diabetes mellitus (DM), or metabolic dysregulation criteria, while sarcopenia was determined by weight-adjusted skeletal muscle mass. The findings revealed a critical nexus between these conditions and adverse health outcomes. 

Within the MAFLD cohort, both MAFLD (adjusted hazard ratio [aHR] 1.152, 95% CI 1.070–1.241) and sarcopenia (aHR 1.123, 95% CI 1.042–1.210) independently correlated with increased all-cause mortality after meticulous adjustment for demographic and lifestyle factors. A compounding influence emerged when exploring combined effects, illustrating an additive impact of MAFLD and sarcopenia. This combined presence substantially amplified the risk of mortality (aHR 1.247, 95% CI 1.132–1.373) and heightened liver fibrosis levels (adjusted odds ratio [aOR] 2.296, 95% CI 1.718–3.069 assessed by NFS score >0.676; aOR 2.218, 95% CI 1.788–2.752 assessed by FIB-4 score >1.3) in comprehensive models accounting for multiple factors. 

The implications of this study extend beyond mortality. They shed light on the intricate interplay between MAFLD and sarcopenia in precipitating liver fibrosis, signifying their additive effect in escalating both mortality rates and liver fibrosis severity. These findings underscore the urgent need for innovative therapeutic approaches aimed at augmenting skeletal muscle mass, particularly in individuals afflicted with MAFLD, to potentially mitigate adverse health outcomes, lower mortality risks, and attenuate liver fibrosis progression.

Source: nature.com/articles/s41387-023-00250-6