Sarcopenia Among Patients With Metabolic Dysfunction-associated Steatotic Liver Disease

Prior treatment

• Medication and/or substance use which may lead to hepatic steatosis and/or injury
• Use of anabolic steroids

Other illness

• Chronic hepatitis C virus and/or hepatitis B virus infection
• Autoimmune hepatitis
• Hepatic and/or extrahepatic neoplastic disorders
• Eating disorders
• Comorbidities such as neuromuscular, pulmonary, and renal disorders

Age

• Age less than 18 years old or more than 65 years old

Other

• Pregnant patients
• Any alcohol consumption

• 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 \[8\]:
• BMI ≥ 25 kg/m2 or waist circumference \> 94 cm in men, \> 80 cm in women
• 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
• Blood pressure ≥ 130/85 mmHg or specific drug treatment
• Plasma triglycerides ≥ 150 mg/dL (≥ 1.70 mmol/L) or specific drug treatment
• 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) \[9\].