Gupta V, Krishnamoorthy A. Skeletal muscle alterations in metabolic dysfunction-associated steatotic liver disease: A critical review of diagnostic, mechanistic, and therapeutic intersections. World J Gastroenterol 2025; 31(31): 110481 [DOI: 10.3748/wjg.v31.i31.110481]
Corresponding Author of This Article
Vaynika Gupta, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom. vxg381@student.bham.ac.uk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 21, 2025; 31(31): 110481 Published online Aug 21, 2025. doi: 10.3748/wjg.v31.i31.110481
Skeletal muscle alterations in metabolic dysfunction-associated steatotic liver disease: A critical review of diagnostic, mechanistic, and therapeutic intersections
Vaynika Gupta, Ashwin Krishnamoorthy
Vaynika Gupta, College of Medicine and Health, University of Birmingham, Birmingham B15 2TT, United Kingdom
Ashwin Krishnamoorthy, Department of Upper GI Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom
Author contributions: Gupta V wrote the original draft and completed editing; Krishnamoorthy A contributed to the conceptualization, reviewing and editing. All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vaynika Gupta, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom. vxg381@student.bham.ac.uk
Received: June 10, 2025 Revised: June 30, 2025 Accepted: July 25, 2025 Published online: August 21, 2025 Processing time: 72 Days and 18.6 Hours
Abstract
Metabolic dysfunction-associated steatotic liver disease is increasingly understood to be closely linked with skeletal muscle alterations, such as sarcopenia, myosteatosis, and metabolic dysregulation, which play a key role in its pathogenesis and progression. Recent literature, including an article by Isakov, highlights the bidirectional interactions between muscle and liver, underscoring shared mechanisms such as insulin resistance, inflammation, and myokine imbalance. This letter reflects on key findings from the review, noting strengths such as its integration of mechanistic insights, discussion of emerging biomarkers, and emphasis on lifestyle and pharmacological interventions. It also identifies areas for further development, including standardization of diagnostic criteria and more rigorous evaluation of translational data. As muscle health gains prominence in metabolic dysfunction-associated steatotic liver disease research, multidisciplinary strategies that target both hepatic and muscular systems may offer more effective avenues for prevention and treatment.
Core Tip: Skeletal muscle alterations, such as sarcopenia, myosteatosis, and metabolic dysregulation, are increasingly common in pathogenesis and progression of metabolic dysfunction-associated steatotic liver disease. Underlying mechanisms, including insulin resistance, inflammation, and myokine imbalance, along with emerging biomarkers offer opportunities to study lifestyle and pharmacological interventions such as glucagon-like peptide-1 agonists. Further development must build on gaps in current literature, standardize diagnostic criteria and evaluate translational data for clinical applicability.
