Commentary
Physical inactivity and sedentary lifestyle have contributed to the epidemic of obesity and NAFLD. Moreover, NAFLD and sarcopenia have similar pathophysiological profiles. ZM Younossi et al. assessed the association between physical activity, NAFLD, and sarcopenia, and their contributions to mortality, using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 with Linked Mortality file (through 2015).
Of 4,611 NHANES participants, NAFLD was present in 29.3%, of whom 17.7% had sarcopenia. Of the NAFLD group, 46.3% was inactive. Sarcopenia was significantly and inversely related to higher physical activity level, both amongst NAFLD and non-NAFLD.
During a median follow-up of 13.5 years, amongst those who died with NAFLD, 33.0% had sarcopenia and 54.3% were inactive. Compared with NAFLD without sarcopenia, NAFLD with sarcopenia was associated with a higher risk of all-cause (HR = 1.78), cardiac-specific (HR = 3.19), and cancer-specific mortality (HR = 2.12).
Sarcopenia should be a part of clinical assessment of patients with NAFLD. Treatment of NAFLD should include optimal management of sarcopenia.