Role of Sarcopenia in Paediatric Non-Alcoholic Fatty Liver Disease


Dr Eirini (Serena) Kyrana of Leeds Children’s Hospital/Leeds Teaching Hospitals NHS Trust discusses her research and what it means for the future of treating childhood liver disease.

What is this study looking at?

Muscle wasting, also known as sarcopenia, has for many years been associated with chronic disease including chronic liver disease. It is now clear that sarcopenia can often exist undetected in the presence of obesity and still exert its harmful effects.

The prevalence of sarcopenia in paediatric NAFLD and its associated risks are unknown.This study will assess the body composition of children with non-alcoholic fatty liver disease.

This will be done by established, simple, painless methods that require minimal cooperation. The study will aim to identify the relationship between sarcopenia and degree of steatosis, fibrosis and inflammation on liver biopsy and any associations with molecules associated with muscle growth, insulin resistance and liver fibrosis.

Why is this research important?

NAFLD has become the most common paediatric chronic liver disease in industrialised countries and in the United States (in adults) the second leading cause for liver transplantation. NAFLD in children provides a pure model of the disease as children have significantly less additional conditions like heart disease and cancer.

Children are also more likely to have a significant benefit from the development of effective interventions. In addition, the benefits for society from treating children, who are carrying this condition into adulthood is also greater.

There has been no previous paediatric study, to our knowledge, exploring the association of sarcopenia with increased fibrosis and/or inflammation in the context of NAFLD. No study in children with NAFLD has investigated the various myokines (products released by muscle cells) and adipokines (protein secreted by body fat) in relation to muscle mass.

This study would help to generate data that would provide the basis for developing larger multicentre studies looking at the effect of interventions like exercise and even interventions like GDF15 stimulators or myostatin inhibitors when they come into practice.

What about the future?

The long-term goal for this study is to gain insight that will provide the basis of successful interventions and potential treatment strategies in the near future.

Successful interventions in childhood would have exponential benefits both for the child and for our society, as NAFLD is a condition carrying significant morbidity and mortality into the future.

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