Sarcopenia – 2021

Összefoglaló. A sarcopenia progresszív, generalizált vázizombetegség az izomtömeg fogyásával és az izomfunkció romlásával, számos szövődménnyel, rossz prognózissal. A sarcopeniát eredetileg életkorfüggő, idősekben jelentkező kórképnek írták le (primaer sarcopenia). Később derült ki, hogy fiatal- és középkorú személyeknél is előfordul, különböző betegségekhez társulva (secundaer sarcopenia). A közlemény áttekintést ad a betegség patofiziológiájáról, a fizikai inaktivitás, az inzulinrezisztencia, a krónikus gyulladás, a citokinek, hepatokinek és miokinek szerepéről az izomkárosodásban, valamint az izom, a zsírszövet és a máj funkcionális kapcsolatairól nem alkoholos zsírmájban és cirrhosisban. A diagnózis felállítását számos funkcionális próba, illetve vizsgálóeljárás teszi lehetővé. Az izomerő-csökkenés igazolása a legfontosabb paraméter (kézszorító erő). Az izomtömegvesztést kettős energiájú röntgenabszorpciometria, bioelektromosimpedancia-analízis, komputertomográfia vagy mágneses rezonanciás képalkotó vizsgálat mutathatja ki, megerősítve a kórismét, a fizikai teljesítmény csökkenése pedig a sarcopenia súlyosságát jelzi. A sarcopenia kezelése és a progresszió prevenciója a fiatalkorban elkezdett és élethosszig tartó rendszeres fizikai aktivitáson, a protein-kalória túltápláláson és a gyógyszeres terápián alapul, beleértve a D-vitamin és a tesztoszteron pótlását, az elágazó láncú aminosavak és az L-karnitin adását. Másodlagos sarcopeniában az alapbetegség kezelése is szükséges. Orv Hetil. 2021; 162(1): 3–12. Summary. Sarcopenia is a progressive, generalized skeletal muscle disease with the loss of muscle mass and function, associated with adverse outcomes and poor prognosis. Sarcopenia first was regarded as an age-related disorder of older people (primary sarcopenia). Later it turned out that it can also occur in young age due to a range of chronic disorders such as cancer, anorexia or malnutrition (secondary sarcopenia). This paper overviews the pathophysiology of sarcopenia and the factors involved in the muscle mass loss, i.e., physical inactivity, insulin resistance, low-grade chronic inflammation, hepatokines and myokines. The basic feature is the imbalance between proteolysis and protein synthesis that leads to muscle atrophy. We discuss the relationship between liver, muscle and adipose tissue in non-alcoholic fatty liver disease and cirrhosis. To diagnose sarcopenia, there are a range of tests and tools that measure muscle strength and muscle mass as well as physical performance. The low muscle strength (hand grip strength) is the primary parameter of the diagnosis, the best measure of muscle function. The loss of skeletal muscle mass assessed by dual-energy X-ray absorptiometry, bioelectric impedance analysis, computer tomography, or magnetic resonance imaging confirms diagnosis, while the decrease in physical performance reflects severe sarcopenia. For the treatment and prevention of progression, the most important is the regular physical activity started from early adulthood, and healthy diet containing protein-calorie hyperalimentation. In addition, a pharmacotherapy with the supplementation of vitamin D and testosterone, furthermore, the administration of L-carnitine and branched-chain amino acids can be recommended. In the case of secondary sarcopenia, the underlying disease also requires treatment. Orv Hetil. 2021; 162(1): 3–12.

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Prevalence of Sarcopenia According to the Method Used to Determine Physical Performance

10.5772/intechopen.100467 ◽

2021 ◽

Author(s):

Carlos Sáez ◽

Sara García-Isidoro

Keyword(s):

Skeletal Muscle ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Adverse Outcomes ◽

Simplified Model ◽

Perfect Agreement ◽

Significant Difference ◽

Muscle Disorder ◽

Low Levels

Sarcopenia is currently defined as a progressive and generalized skeletal muscle disorder that occurs with advancing age and is associated with an increased likelihood of adverse outcomes. Low levels of measures for muscle strength, muscle quantity, and physical performance define sarcopenia. In this chapter, we will see that the prevalence of a low value of physical performance will be different according to the method used to measure this parameter, and thus, it would be foreseeable to think that the prevalence of sarcopenia will also be different according to the method used. However, despite the differences found in physical performance, we will show that the prevalence of sarcopenia appears to be regardless of the method used for physical performance, and therefore, how is it possible that having a significant difference in the prevalence of physical performance depending on the method chosen, the prevalence of sarcopenia has an almost perfect agreement? To answer these questions, a new simplified model is studied, defining sarcopenia as low muscle strength and low muscle mass and without taking physical performance into account. Finally, we will see that, indeed, physical performance does not seem to be decisive or necessary for the diagnosis of sarcopenia.

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An update on methods for sarcopenia diagnosis: from bench to bedside

Italian Journal of Medicine ◽

10.4081/itjm.2018.995 ◽

2018 ◽

Vol 12 (2) ◽

pp. 97 ◽

Cited By ~ 1

Author(s):

Andrea P. Rossi ◽

Sofia Rubele ◽

Alessia D'Introno ◽

Elena Zoico ◽

Piero Bradimarte ◽

...

Keyword(s):

Muscle Strength ◽

Diagnostic Criteria ◽

Muscle Mass ◽

Physical Performance ◽

Adverse Outcomes ◽

Assessment Tools ◽

Age Related ◽

Current Assessment

Sarcopenia has been recognized as an age-related syndrome characterized by low muscle mass, low muscle strength, and low physical performance that is associated with increased likelihood of adverse outcomes including falls, fractures, hospitalization, frailty and mortality. Therefore, it is necessary to identify the condition early for applying intervention and prevention of the disastrous consequences of sarcopenia if left untreated. Clinical definition and diagnostic criteria for sarcopenia have been developed in the last years and different tools have been proposed for screening subjects with sarcopenia, evaluating the muscle mass, the muscle strength and the physical performance. In this review we analyzed the diagnostic criteria of sarcopenia and examined the current assessment tools used for the diagnosis and screening of sarcopenia.

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The Relationship Between Intermuscular Fat and Physical Performance Is Moderated by Muscle Area in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa161 ◽

2020 ◽

Vol 76 (1) ◽

pp. 115-122

Author(s):

Samaneh Farsijani ◽

Adam J Santanasto ◽

Iva Miljkovic ◽

Robert M Boudreau ◽

Bret H Goodpaster ◽

...

Keyword(s):

Skeletal Muscle ◽

Muscle Mass ◽

Physical Performance ◽

Functional Limitations ◽

Negative Association ◽

Muscle Area ◽

Cross Sectional ◽

Age Related ◽

Intermuscular Fat ◽

The Mean

Abstract Background Age-related deposition of fat in skeletal muscle is associated with functional limitations. Skeletal muscle fat may be present in people with preserved muscle mass or accompanied by muscle wasting. However, it is not clear if the association between muscle fat deposition and physical performance is moderated by muscle mass. Objective To determine whether the association between midthigh intermuscular fat and physical performance is moderated by muscle area. Methods We performed a cross-sectional analysis of the Health, Aging, and, Body Composition (ABC) study data collected in 2002–2003 (n = 1897, women: 52.2%). Midthigh muscle cross-sectional area (by computed tomography) and physical performance measures were compared across quartiles of intermuscular fat absolute area. Moderation analysis was performed to determine the conditional effect of intermuscular fat on physical performance as a function of muscle area. Conditional effects were evaluated at three levels of muscle area (mean and ± 1 standard deviation [SD]; 213.2 ± 53.2 cm2). Results Simple slope analysis showed that the negative association between intermuscular fat area (cm2) and leg strength (N·m) was of greater magnitude (beta coefficient [b], 95% confidence interval [CI] = −0.288 [−0.427, −0.148]) in participants with greater muscle area (ie, 1 SD above the mean) compared to those with lower muscle area (ie, at mean [b = −0.12 {−0.248, 0.008}] or 1 SD below the mean [b = 0.048 {−0.122, 0.217}]). Similarly, the negative association of intermuscular fat with 400-m walk speed (m/s) and chair stand (seconds) was greater in those with higher muscle areas (p < .001) compared to those with lower muscle areas. Conclusions The association between higher intermuscular fat area and impaired physical function in aging is moderated by muscle area.

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Sarcopenia in chronic kidney disease – A brief review

Portuguese Journal of Nephrology & Hypertension ◽

10.32932/pjnh.2021.07.129 ◽

2021 ◽

Vol 35 (2) ◽

Author(s):

Beatriz Donato ◽

◽

Catarina Teixeira ◽

Sónia Velho ◽

Edgar Almeida ◽

...

Keyword(s):

Skeletal Muscle ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Muscle Mass ◽

Physical Performance ◽

Functional Independence ◽

Muscle Dysfunction ◽

Skeletal Muscle Dysfunction ◽

Age Related ◽

The Impact

Sarcopenia is a progressive age -related loss of muscle mass associated with a decline in muscle function and physical performance. Patients with chronic kidney disease experience substantial loss of muscle mass, weakness, and poor physical performance. Indeed, with the progression of chronic kidney disease, skeletal muscle dysfunction contributes to mobility limitation, loss of functional independence, and vulnerability to disease complications. There is a lack of robust data on the negative effect of the impact of kidney disease on skeletal muscle dysfunction, as well as on screening and treatment strategies that can be used in clinical practice to prevent functional decline and disability. Therefore, sarcopenia may be an underestimated condition with major implications for people with chronic kidney disease, even before the start of dialysis, which makes research into this topic necessary. The purpose of this review is to expand on some fundamental topics of sarcopenia, with an emphasis on the setting of chronic kidney disease patients.

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Prevalence of sarcopenia in community-dwelling older adults in Ireland: comparison of EWGSOP1 and EWGSOP2 definitions

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001093 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Caoileann Murphy ◽

Aoibheann McMorrow ◽

Ellen Flanagan ◽

Helen Cummins ◽

Sinead McCarthy ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Clinical Investigation ◽

Community Dwelling ◽

Muscle Disease ◽

Cross Sectional ◽

European Working ◽

Community Dwelling Older Adults

AbstractSarcopenia is a muscle disease rooted in adverse muscle changes that accrue across a lifetime. It is an independent risk factor for numerous adverse health outcomes. In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a definition for the identification of people with sarcopenia (EWGSOP1). In 2018, this definition was updated based on the newest evidence (EWGSOP2), with the focus now on low muscle strength rather than low muscle quantity as the key characteristic of sarcopenia. In addition, EWGSOP2 provides clear cut-off points for measurements of variables that identify sarcopenia. The aim of this study was to determine the prevalence of sarcopenia among community-dwelling older adults in Ireland for the first time and to assess agreement between the EWGSOP1 and EWGSOP2 definitions. In a cross-sectional analysis, 490 community-dwelling adults (age 78.4 ± 8.0 y, body mass index 27.6 ± 5.1 kg/m2) were assessed. Skeletal muscle mass was estimated using bioelectrical impedance analysis, muscle strength was measured via handgrip dynamometry and physical performance via the Short Physical Performance Battery. Sarcopenia was defined according to both the 2010 criteria (EWGSOP1) and the updated 2018 criteria (EWGSOP2). Using the EWGSOP1 criteria, the prevalence of sarcopenia was 7.1% (2.6% sarcopenia, 4.5% severe sarcopenia) and 3.6% were classified as pre-sarcopenic (low muscle mass without a decrement in strength or physical performance). Using the EWGSOP2 criteria, the prevalence of sarcopenia was 5.5% (1.6% sarcopenia, 3.9% severe sarcopenia) and 23.4 % were classified as having low strength but without a decrement in muscle mass. Five of the participants who were classified as sarcopenic (2 sarcopenia, 3 severe sarcopenia) by EWGSOP1 were classified as “normal” using the EWGSOP2 criteria. In conclusion, the prevalence of sarcopenia in community-dwelling older adults in Ireland is in line with the prevalence reported in other European countries using the EWGSOP1 criteria (3.3–11.4 %). To our knowledge this is the first study to compare the prevalence based on the EWGSOP1 and the EWGSOP2 criteria. We report a slightly lower prevalence using the EWGSOP2 definition compared to the EWGSOP1 definition. Importantly however, in contrast to EWGSOP1, the EWGSOP2 definition identified a substantial proportion of older adults with poor strength in the absence of overt sarcopenia (23.4%). These older adults represent a group who would benefit from further clinical investigation and intervention.

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A Prospective Observational Study Evaluating Sarcopenia By Using the Bioelectrical Impedance Analysis in Elderly Patients with Hematologic Malignancies

Blood ◽

10.1182/blood-2018-99-114545 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 4851-4851 ◽

Cited By ~ 1

Author(s):

Takahiro Kamiya ◽

Kota Mizuno ◽

Shinji Ogura ◽

Chisako Ito ◽

Yuriko Fujita ◽

...

Keyword(s):

Skeletal Muscle ◽

Muscle Strength ◽

Elderly Patients ◽

Muscle Mass ◽

Physical Performance ◽

Bioelectrical Impedance Analysis ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Hematologic Malignancies ◽

Skeletal Muscle Index

Abstract [Introduction] Sarcopenia is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Population-based studies reported that the prevalence of sarcopenia in Japanese healthy adults aged≥60 years was 8.5% among men and 8.0% among women. Sarcopenia was recently identified as a poor prognostic factor in patients with solid tumors. In cancer patients, sarcopenia is associated with treatment failure, chemotherapy toxicity, and a shorter time to tumor progression related to survival. In contrast to solid tumors, the clinical relevance of sarcopenia in hematologic malignancies is still unknown. The present study investigated the prevalence of sarcopenia based on the criteria of the Asian Working Group for Sarcopenia (AWGS) in elderly patients with hematologic malignancies. [Patients and Methods] We prospectively analyzed 56 elderly patients aged≥60 years with hematologic malignancies diagnosed at our institution between 2015 and 2018. Appendicular skeletal muscle mass (ASM) was measured at diagnosis by using multifrequency bioelectrical impedance analysis (BIA) (InBody 720). BIA is suitable for body composition monitoring in elderly patients as a fast, noninvasive, and convenient method. Skeletal muscle index (SMI) was defined as the ratio of ASM divided by height in square centimeters. We also evaluated physical function by using short physical performance buttery (SPPB). Sarcopenia was defined according to the AWGS algorithm, in which the patient has low muscle mass, and low muscle strength or low physical performance. Low muscle mass was defined as a skeletal muscle index (SMI: ASM/height2) of <7.0kg/m2 in men and <5.7kg/m2 in women. Pre-sarcopenia was defined as having only low muscle mass. Low muscle strength was defined as a handgrip strength of <26kg in men and <18kg in women; and low physical performance, as a gait speed of <0.8m/sec. The study protocol was approved by the Institutional Review Board of Yokohama Municipal Citizen's Hospital, and it was carried out in accordance with the Declaration of Helsinki. [Results] Median age at diagnosis was 77 years (60-93 years), with 34 males and 22 females. The diagnosis included non-Hodgkin lymphoma (NHL, n=36), multiple myeloma (MM, n=9), myelodysplastic syndrome (MDS, n=10), and acute myeloid leukemia (AML, n=1). The prevalence of low muscle mass (pre-sarcopenia) was 41% (14/34) in men and 77% (17/22) in women. The prevalence of low muscle strength was 35% (12/34) in men and 41% (9/22) in women. The prevalence of low physical performance status (Gait speed:<0.8m/sec) was 6% (2/34) in men and 9% (2/22) in women. The prevalence of sarcopenia based on a diagnosis of low muscle mass, low muscle strength, and low physical performance was 24% (8/34) in men and (8/22) 36% in women. The prevalence of low SPPB score (<10) was 9% (3/34) in men and 18% (4/22) in women. Among 36 NHL patients, the diagnosis included DLBCL (n=15), FL (n=10), MALT (n=3), SMZBCL (n=3), MCL (n=2), and others. The prevalence of sarcopenia was 25% (5/20) in men and 50% (8/16) in women. The mean age was 83 years in the sarcopenic group (n=13, 36%) and 73 years in the non-sarcopenic group (n=23, 64%) (p=0.0001). Sarcopenic patients displayed a similar level of serum albumin, LDH, sIL2-R, and BMI when compared with patients who were not sarcopenic. However, sarcopenic patients displayed significantly lower levels of serum dehydroepiandrosterone-sulfate (DHEA-S) and a higher CCI score than patients who were not sarcopenic. Sarcopenic patients failed to complete the treatment planned as compared with non-sarcopenic patients (p=0.001). [Conclusion] These results demonstrated that the prevalence of sarcopenia in elderly patients with hematologic malignancies is higher than that in the Japanese general elderly population. In particular, the prevalence of sarcopenia in female NHL patients is higher than that in male NHL patients. Several factors such as age, serum DHEA-S or comorbidities may affect the incidence of sarcopenia. Since our results are based on a small-sized analysis, further large prospective studies are warranted to verify this conclusion. Disclosures No relevant conflicts of interest to declare.

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Effect of Loquat Leaf Extract on Muscle Strength, Muscle Mass, and Muscle Function in Healthy Adults: A Randomized, Double-Blinded, and Placebo-Controlled Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2016/4301621 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

Young Hye Cho ◽

Sang Yeoup Lee ◽

Cheol Min Kim ◽

Nam Deuk Kim ◽

Sangmin Choe ◽

...

Keyword(s):

Skeletal Muscle ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Muscle Function ◽

Leaf Extract ◽

Handgrip Strength ◽

Healthy Adults ◽

Controlled Study ◽

Study Results

Ursolic acid (UA) is the major active component of the loquat leaf extract (LLE) and several previous studies have indicated that UA may have the ability to prevent skeletal muscle atrophy. Therefore, we conducted a randomized, double-blind, and placebo-controlled study to investigate the effects of the LLE on muscle strength, muscle mass, muscle function, and metabolic markers in healthy adults; the safety of the compound was also evaluated. We examined the peak torque/body weight at 60°/s knee extension, handgrip strength, skeletal muscle mass, physical performance, and metabolic parameters at baseline, as well as after 4 and 12 weeks of intervention. Either 500 mg of LLE (50.94 mg of UA) or a placebo was administered to fifty-four healthy adults each day for 12 weeks; no differences in muscle strength, muscle mass, and physical performance were observed between the two groups. However, the right-handgrip strength of female subjects in the LLE group was found to be significantly better than that of subjects in the control group (P=0.047). Further studies are required to determine the optimal dose and duration of LLE supplementation to confirm the first-stage study results for clinical application. ClinicalTrials.gov Identifier isNCT02401113.

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Nutrition and microRNAs: Novel Insights to Fight Sarcopenia

Antioxidants ◽

10.3390/antiox9100951 ◽

2020 ◽

Vol 9 (10) ◽

pp. 951

Author(s):

Alessandra Barbiera ◽

Laura Pelosi ◽

Gigliola Sica ◽

Bianca Maria Scicchitano

Keyword(s):

Skeletal Muscle ◽

Muscle Mass ◽

Molecular Mechanisms ◽

Muscle Protein ◽

Low Grade ◽

Protein Homeostasis ◽

Dietary Interventions ◽

Physiological Processes ◽

Age Related ◽

And Function

Sarcopenia is a progressive age-related loss of skeletal muscle mass and strength, which may result in increased physical frailty and a higher risk of adverse events. Low-grade systemic inflammation, loss of muscle protein homeostasis, mitochondrial dysfunction, and reduced number and function of satellite cells seem to be the key points for the induction of muscle wasting, contributing to the pathophysiological mechanisms of sarcopenia. While a range of genetic, hormonal, and environmental factors has been reported to contribute to the onset of sarcopenia, dietary interventions targeting protein or antioxidant intake may have a positive effect in increasing muscle mass and strength, regulating protein homeostasis, oxidative reaction, and cell autophagy, thus providing a cellular lifespan extension. MicroRNAs (miRNAs) are endogenous small non-coding RNAs, which control gene expression in different tissues. In skeletal muscle, a range of miRNAs, named myomiRNAs, are involved in many physiological processes, such as growth, development, and maintenance of muscle mass and function. This review aims to present and to discuss some of the most relevant molecular mechanisms related to the pathophysiological effect of sarcopenia. Besides, we explored the role of nutrition as a possible way to counteract the loss of muscle mass and function associated with ageing, with special attention paid to nutrient-dependent miRNAs regulation. This review will provide important information to better understand sarcopenia and, thus, to facilitate research and therapeutic strategies to counteract the pathophysiological effect of ageing.

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Assessment of sarcopenia in patients with fibromyalgia

Rheumatology International ◽

10.1007/s00296-021-04973-6 ◽

2021 ◽

Author(s):

Abeline Kapuczinski ◽

Muhammad S. Soyfoo ◽

Sandra De Breucker ◽

Joëlle Margaux

Keyword(s):

Skeletal Muscle ◽

Muscle Strength ◽

Older People ◽

Muscle Mass ◽

Physical Performance ◽

Muscle Function ◽

Skeletal Muscle Mass ◽

Fibromyalgia Impact Questionnaire ◽

Control Group ◽

European Working

AbstractFibromyalgia is a chronic disorder characterized by persistent widespread musculoskeletal pain. Patients with fibromyalgia have reduced physical activity and increased sedentary rate. The age-associated reduction of skeletal muscle mass and function is called sarcopenia. The European Working Group on Sarcopenia in Older People developed a practical clinical definition and consensus diagnostic criteria for sarcopenia. Loss of muscle function is common in fibromyalgia and in the elderly. The goal of this study is to determine whether the reduction of muscle function in fibromyalgia is related to sarcopenia according to the European Working Group on Sarcopenia in Older People criteria. Forty-five patients with fibromyalgia and thirty-nine healthy control female subjects were included. All the participants were assessed by Fibromyalgia Impact Questionnaire and SARC-F questionnaire. Muscle mass was evaluated by bioimpedance analysis, muscle strength by handgrip strength test and physical performance with the Short Physical Performance Battery. Fibromyalgia Impact Questionnaire and SARC-F scores were statistically significantly higher in the fibromyalgia group than in the control group, showing severe disease and a higher risk of sarcopenia in the fibromyalgia group (p < 0.001). Muscle strength and physical performance were statistically significantly lower in the group with fibromyalgia than in the control group (p < 0.001). There was no statistical difference between fibromyalgia and control groups regarding skeletal muscle mass (p = 0.263). Our study demonstrated a significant reduction in muscle function in fibromyalgia patients without any loss of muscle mass. Loss of muscle function without decrease in muscle mass is called dynapenia.

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Impact of exercise training on sarcopenia associated with non-alcoholic fatty liver disease (NAFLD) in humans: A systematic review and meta-analysis

10.1101/2020.09.05.20189100 ◽

2020 ◽

Author(s):

Andrea Gonzalez ◽

Mayalen Valero-Breton ◽

Camila Huerta-Salgado ◽

Oscar Achiardi ◽

Felipe Simon ◽

...

Keyword(s):

Systematic Review ◽

Liver Disease ◽

Muscle Strength ◽

Exercise Training ◽

Muscle Mass ◽

Physical Performance ◽

Meta Analysis ◽

Control Groups ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Objective: To conduct a systematic review and meta-analyses to assess the efficacy of physical exercise on strength, muscle mass and physical function in adult patients with non-alcoholic fatty liver disease (NAFLD). Design: We conducted a systematic review and meta-analysis of seven studies to investigate the effect of exercise training interventions in muscle strength, muscle mass and physical performance. Data sources: We identified relevant randomised controlled trials (RCT) in electronic databases (PubMed, CINAHL and Scopus). Eligibility criteria: We selected seven RCTs from 66 screened studies. The inclusion criteria were peer-reviewed and English writing articles that included adult patients with liver disease of non-alcoholic origin, applied resistance training, endurance training or both, and assayed at least one variable of sarcopenia. Results: Physical performance criterion improved in the exercise groups (mean differences [MD] 8.26 mL/Kg*min [95% CI 5.27 to 11.24 mL/Kg*min], p < 0.0001) versus the control groups; muscle mass, determined as lean body mass (LBM), showed no evidence of the beneficial effects of exercise versus the control groups (MD 1.01 Kg [95% CI -1.78 to 3.80 Kg], p = 0.48); we did not include muscle strength, as none of the selected studies evaluated it. Summary/conclusion: Exercise training is a useful intervention strategy to treat sarcopenia in patients with NAFLD; it increases their physical performance in the form of aerobic capacity but does not affect LBM. Future research should include muscle strength assessments and resistance training to evaluate the effects of exercise training on sarcopenia in NAFLD patients. PROSPERO reference number CRD42020191471

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