Background:
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease in the United States, affecting approximately 38% of adults, and projected to exceed 120 million individuals by 2050. Its clinical disease course is heterogenous, ranging from long-term stability to rapid progression toward metabolic dysfunction-associated steatohepatitis (MASH) and cirrhosis. A major yet underrecognized determinant of this variability is muscle health, which is tightly linked to metabolic dysfunction. Poor muscle health spans three domains: 1) mass (sarcopenia), 2) function (frailty and reduced strength), and 3) quality (myosteatosis), and affects 1 in 4 patients with MASLD4-10 contributing to liver- and non-liver-related morbidity and mortality
Study design:
The objective of this proposal is to comprehensively evaluate domains of metabolic syndrome myopathy in patients with MASLD across the spectrum of hepatic fibrosis. To accomplish this, we will build upon an established prospective MASLD cohort infrastructure to enroll 125 patients with MASLD, stratified by fibrosis stage, to deeply characterize components of metabolic syndrome myopathy across the spectrum of hepatic fibrosis. Baseline body composition will be measured with anthropometrics and bioelectrical impedance (BIA); muscle mass and quality will be assessed with the skeletal muscle mass index and muscle fat infiltration by phase angle using BIA, respectively; and muscle function will be assessed using the Liver Frailty Index. In addition, we will collect questionnaire data on health-related quality of life (HRQoL), physical activity, and dietary patterns, along with comprehensive laboratory measures.