Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver Cirrhosis
Liver cirrhosis is frequently accompanied by disease-related malnutrition (DRM) and sarcopenia, defined as loss of skeletal muscle mass and function. DRM and sarcopenia often coexist in cirrhotic patients and are associated with increased morbidity and mortality. The clinical manifestation of both c...
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MDPI AG
2020-07-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/21/15/5357 |
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| author | Fatuma Meyer Karen Bannert Mats Wiese Susanne Esau Lea F. Sautter Luise Ehlers Ali A. Aghdassi Cornelia C. Metges Leif-A. Garbe Robert Jaster Markus M. Lerch Georg Lamprecht Luzia Valentini |
| author_facet | Fatuma Meyer Karen Bannert Mats Wiese Susanne Esau Lea F. Sautter Luise Ehlers Ali A. Aghdassi Cornelia C. Metges Leif-A. Garbe Robert Jaster Markus M. Lerch Georg Lamprecht Luzia Valentini |
| author_sort | Fatuma Meyer |
| collection | DOAJ |
| description | Liver cirrhosis is frequently accompanied by disease-related malnutrition (DRM) and sarcopenia, defined as loss of skeletal muscle mass and function. DRM and sarcopenia often coexist in cirrhotic patients and are associated with increased morbidity and mortality. The clinical manifestation of both comorbidities are triggered by multifactorial mechanisms including reduced nutrient and energy intake caused by dietary restrictions, anorexia, neuroendocrine deregulation, olfactory and gustatory deficits. Maldigestion and malabsorption due to small intestinal bacterial overgrowth, pancreatic insufficiency or cholestasis may also contribute to DRM and sarcopenia. Decreased protein synthesis and increased protein degradation is the cornerstone mechanism to muscle loss, among others mediated by disease- and inflammation-mediated metabolic changes, hyperammonemia, increased myostatin and reduced human growth hormone. The concise pathophysiological mechanisms and interactions of DRM and sarcopenia in liver cirrhosis are not completely understood. Furthermore, most knowledge in this field are based on experimental models, but only few data in humans exist. This review summarizes known and proposed molecular mechanisms contributing to malnutrition and sarcopenia in liver cirrhosis and highlights remaining knowledge gaps. Since, in the prevention and treatment of DRM and sarcopenia in cirrhotic patients, more research is needed to identify potential biomarkers for diagnosis and development of targeted therapeutic strategies. |
| first_indexed | 2024-03-10T18:08:42Z |
| format | Article |
| id | doaj.art-04aed614db23412dbf7255cfb1c42d80 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-10T18:08:42Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-04aed614db23412dbf7255cfb1c42d802023-11-20T08:13:30ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672020-07-012115535710.3390/ijms21155357Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver CirrhosisFatuma Meyer0Karen Bannert1Mats Wiese2Susanne Esau3Lea F. Sautter4Luise Ehlers5Ali A. Aghdassi6Cornelia C. Metges7Leif-A. Garbe8Robert Jaster9Markus M. Lerch10Georg Lamprecht11Luzia Valentini12Department of Agriculture and Food Sciences, Neubrandenburg Institute for Evidence-Based Dietetics (NIED), University of Applied Sciences Neubrandenburg, 17033 Neubrandenburg, GermanyDivision of Gastroenterology and Endocrinology, Department of Internal Medicine II, University Medicine Rostock, 18057 Rostock, GermanyDivision of Gastroenterology, Endocrinology and Nutritional Medicine, Department of Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, GermanyDepartment of Agriculture and Food Sciences, Neubrandenburg Institute for Evidence-Based Dietetics (NIED), University of Applied Sciences Neubrandenburg, 17033 Neubrandenburg, GermanyDepartment of Agriculture and Food Sciences, Neubrandenburg Institute for Evidence-Based Dietetics (NIED), University of Applied Sciences Neubrandenburg, 17033 Neubrandenburg, GermanyDivision of Gastroenterology and Endocrinology, Department of Internal Medicine II, University Medicine Rostock, 18057 Rostock, GermanyDivision of Gastroenterology, Endocrinology and Nutritional Medicine, Department of Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, GermanyInstitute of Nutritional Physiology ‘Oskar Kellner’, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, GermanyDepartment of Agriculture and Food Sciences, University of Applied Sciences Neubrandenburg, 17033 Neubrandenburg, GermanyDivision of Gastroenterology and Endocrinology, Department of Internal Medicine II, University Medicine Rostock, 18057 Rostock, GermanyDivision of Gastroenterology, Endocrinology and Nutritional Medicine, Department of Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, GermanyDivision of Gastroenterology and Endocrinology, Department of Internal Medicine II, University Medicine Rostock, 18057 Rostock, GermanyDepartment of Agriculture and Food Sciences, Neubrandenburg Institute for Evidence-Based Dietetics (NIED), University of Applied Sciences Neubrandenburg, 17033 Neubrandenburg, GermanyLiver cirrhosis is frequently accompanied by disease-related malnutrition (DRM) and sarcopenia, defined as loss of skeletal muscle mass and function. DRM and sarcopenia often coexist in cirrhotic patients and are associated with increased morbidity and mortality. The clinical manifestation of both comorbidities are triggered by multifactorial mechanisms including reduced nutrient and energy intake caused by dietary restrictions, anorexia, neuroendocrine deregulation, olfactory and gustatory deficits. Maldigestion and malabsorption due to small intestinal bacterial overgrowth, pancreatic insufficiency or cholestasis may also contribute to DRM and sarcopenia. Decreased protein synthesis and increased protein degradation is the cornerstone mechanism to muscle loss, among others mediated by disease- and inflammation-mediated metabolic changes, hyperammonemia, increased myostatin and reduced human growth hormone. The concise pathophysiological mechanisms and interactions of DRM and sarcopenia in liver cirrhosis are not completely understood. Furthermore, most knowledge in this field are based on experimental models, but only few data in humans exist. This review summarizes known and proposed molecular mechanisms contributing to malnutrition and sarcopenia in liver cirrhosis and highlights remaining knowledge gaps. Since, in the prevention and treatment of DRM and sarcopenia in cirrhotic patients, more research is needed to identify potential biomarkers for diagnosis and development of targeted therapeutic strategies.https://www.mdpi.com/1422-0067/21/15/5357cirrhosismalnutritionsarcopeniaprotein turnoverhypermetabolismhyperammonemia |
| spellingShingle | Fatuma Meyer Karen Bannert Mats Wiese Susanne Esau Lea F. Sautter Luise Ehlers Ali A. Aghdassi Cornelia C. Metges Leif-A. Garbe Robert Jaster Markus M. Lerch Georg Lamprecht Luzia Valentini Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver Cirrhosis International Journal of Molecular Sciences cirrhosis malnutrition sarcopenia protein turnover hypermetabolism hyperammonemia |
| title | Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver Cirrhosis |
| title_full | Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver Cirrhosis |
| title_fullStr | Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver Cirrhosis |
| title_full_unstemmed | Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver Cirrhosis |
| title_short | Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver Cirrhosis |
| title_sort | molecular mechanism contributing to malnutrition and sarcopenia in patients with liver cirrhosis |
| topic | cirrhosis malnutrition sarcopenia protein turnover hypermetabolism hyperammonemia |
| url | https://www.mdpi.com/1422-0067/21/15/5357 |
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