Sarcopenia and MASLD: novel insights and the future

Metabolic dysfunction-associated steatotic liver disease (MASLD; previously known as non-alcoholic fatty liver disease) is the leading cause of chronic liver disease worldwide and is closely linked to the obesity epidemic. MASLD often coexists with sarcopenia, an age-related loss of muscle mass and muscle function. These conditions are closely connected, and metabolic syndrome and its associated metabolic factors have a crucial role in their relationship. Metabolic syndrome considerably affects the risk and progression of MASLD and sarcopenia and promotes their development through various mechanisms. This Review explores the epidemiological link between MASLD and sarcopenia and the effect of metabolic syndrome and its components on both conditions, summarizing current treatment strategies and emerging evidence. To effectively manage both MASLD and sarcopenia, it is crucial to incorporate the five metabolic risk factors of metabolic syndrome into risk assessment and treatment strategies. Future research should continue to investigate the mechanisms linking metabolic syndrome, MASLD and sarcopenia. Establishing standardized definitions of sarcopenia for patients with MASLD and developing personalized treatment strategies through precision medicine will improve diagnosis, interventions and overall patient outcomes.