Frequency and Clinical Correlates of Sarcopenia in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease

Abstract

Introduction Sarcopenia may occur in people with metabolic dysfunction-associated steatotic liver disease; however, the condition's frequency and correlation with liver fibrosis vary by group. Patients with reduced muscle mass and strength may also have a higher metabolic burden and more severe liver involvement. Because these relationships remain inconsistent across available studies, this study aimed to estimate the prevalence of sarcopenia in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and examine its association with clinical findings, metabolic profile, body composition, and liver-related features. Methods A total of 276 people suffering from MASLD were recruited consecutively from a tertiary care hospital for this cross-sectional study. Sarcopenia was diagnosed when low appendicular skeletal muscle mass was present together with either low handgrip strength or reduced physical performance. Severe sarcopenia was defined by the presence of low muscle mass, low muscle strength, and reduced physical performance. Liver steatosis was assessed using the Control Attenuation Parameter (CAP), and liver stiffness measurement (LSM) was utilized to evaluate fibrosis. The differences between patients with and without sarcopenia were assessed. A binary logistic regression was employed, taking into account relevant clinical parameters, to ascertain if sarcopenia and fibrosis were significantly correlated. Results Among 276 patients, the prevalence of sarcopenia was 23.2% (64/276; 95% confidence interval (CI), 18.6-28.5%). Sarcopenia patients were older (54.9 ± 10.6 vs. 48.1 ± 11.1 years; p < 0.001), more likely to have diabetes mellitus (56.2% vs. 32.5%; p < 0.001) and hypertension (57.8% vs. 35.8%; p = 0.002), and less likely to be physically active (21.9% vs. 53.3%; p < 0.001). Sarcopenia patients exhibited greater median LSM (8.4 (6.0-10.6) vs. 6.6 (5.3-8.1) kPa; p < 0.001) and CAP (311.7 ± 28.7 vs. 297.8 ± 34.1 dB/m; p = 0.001). Significant fibrosis was present in 51.6% of patients with sarcopenia compared to 26.4% of patients without sarcopenia (p < 0.001). After adjustment for age, sex, body mass index, and diabetes, sarcopenia remained statistically associated with significant fibrosis (adjusted odds ratio (OR) 2.03, 95% CI 1.10-3.77; p = 0.024). Conclusion Sarcopenia remained statistically associated with significant fibrosis after adjustment for relevant clinical factors; however, further prospective studies are needed to determine whether assessment of muscle status has clinical utility in patients with MASLD.