Molecular Mechanism Contributing to Malnutrition and Sarcopenia in Patients with Liver Cirrhosis
| Autor: | Georg Lamprecht, Ali A. Aghdassi, Karen Bannert, Susanne Esau, Luzia Valentini, Cornelia C. Metges, M. Wiese, Markus M. Lerch, Robert Jaster, Lea F Sautter, Leif-A Garbe, Luise Ehlers, Fatuma Meyer |
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| Rok vydání: | 2020 |
| Předmět: |
Liver Cirrhosis
Cirrhosis Malabsorption hyperammonemia Review malnutrition Anorexia Protein degradation Bioinformatics Catalysis sarcopenia lcsh:Chemistry Inorganic Chemistry 03 medical and health sciences 0302 clinical medicine Small intestinal bacterial overgrowth hypermetabolism medicine Humans Physical and Theoretical Chemistry Muscle Skeletal lcsh:QH301-705.5 Molecular Biology Spectroscopy business.industry cirrhosis protein turnover Organic Chemistry General Medicine musculoskeletal system medicine.disease Computer Science Applications Malnutrition lcsh:Biology (General) lcsh:QD1-999 myostatin 030220 oncology & carcinogenesis Sarcopenia growth hormone Hypermetabolism 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | International Journal of Molecular Sciences, Vol 21, Iss 5357, p 5357 (2020) International Journal of Molecular Sciences |
| ISSN: | 1422-0067 |
| DOI: | 10.3390/ijms21155357 |
| Popis: | Liver cirrhosis is frequently accompanied by disease-related malnutrition (DRM) and sarcopenia, defined as loss of skeletal muscle mass and function. DRM and sarcopenia often coexist in cirrhotic patients and are associated with increased morbidity and mortality. The clinical manifestation of both comorbidities are triggered by multifactorial mechanisms including reduced nutrient and energy intake caused by dietary restrictions, anorexia, neuroendocrine deregulation, olfactory and gustatory deficits. Maldigestion and malabsorption due to small intestinal bacterial overgrowth, pancreatic insufficiency or cholestasis may also contribute to DRM and sarcopenia. Decreased protein synthesis and increased protein degradation is the cornerstone mechanism to muscle loss, among others mediated by disease- and inflammation-mediated metabolic changes, hyperammonemia, increased myostatin and reduced human growth hormone. The concise pathophysiological mechanisms and interactions of DRM and sarcopenia in liver cirrhosis are not completely understood. Furthermore, most knowledge in this field are based on experimental models, but only few data in humans exist. This review summarizes known and proposed molecular mechanisms contributing to malnutrition and sarcopenia in liver cirrhosis and highlights remaining knowledge gaps. Since, in the prevention and treatment of DRM and sarcopenia in cirrhotic patients, more research is needed to identify potential biomarkers for diagnosis and development of targeted therapeutic strategies. |
| Databáze: | OpenAIRE |
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