{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:37:38Z","timestamp":1793144258413,"version":"4.5.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Chronic liver diseases (CLDs) are associated with increased morbidity and mortality. Sarcopenia is an important complication of CLD that can be impacted by several modifiable risk factors. Our aim was to assess the associations between healthy living, sarcopenia, and long\u2010term outcomes among patients with CLD. We used the Third National Health and Nutrition Examination Survey data with National Death Index\u2013linked mortality files. We used the American Heart Association's Life's Simple 7 (LS7) metrics as surrogates of healthy living. The study included 12,032 subjects (34.9% CLDs [0.5% hepatitis B virus (HBV), 1.8% hepatitis C virus (HCV), 5.7% alcohol\u2010associated liver disease (ALD), 26.9% nonalcoholic fatty liver disease (NAFLD)] and 65.1% controls). Prevalence of sarcopenia was higher among NAFLD than other CLDs and the controls (40.7% in NAFLD, 27.2% in ALD, 22.4% in HCV, 16.8% in HBV, and 18.5% in controls; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0&lt;\u20090.001). Among NAFLD and ALD, patients with sarcopenia were less likely to meet ideal LS7 metrics than those without sarcopenia. During 27\u2009years of follow\u2010up, among 4 patients with CLDs and the controls, all\u2010cause cumulative mortality was highest among patients with HCV (35.2%), followed by ALD (34.7%) and NAFLD (29.6%). The presence of sarcopenia was associated with higher risk of all\u2010cause mortality only among subjects with NAFLD (hazard ratio [HR] 1.24; 95% confidence interval [CI] 1.01\u20131.54; <jats:italic toggle=\"yes\">p<\/jats:italic> =\u20090.04). Among subjects with NAFLD, presence of sarcopenia was associated with higher risk of cardiovascular\u2010specific (HR 2.28 [1.71\u20133.05; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0&lt;\u20090.01]), cancer\u2010specific (HR 1.90 [1.37\u20132.65]; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0&lt;\u20090.01), diabetes\u2010specific (HR 6.42 [2.87\u201314.36]; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0&lt;\u20090.01), and liver\u2010specific mortality (HR 2.49 [1.08\u20135.76]; <jats:italic toggle=\"yes\">p<\/jats:italic> =\u20090.04). The multivariable model showed that component of LS7 metrics that provided the strongest protection against sarcopenia were ideal body mass index, ideal blood pressure, ideal physical activity, and ideal glycemic control among subjects with NAFLD subjects. <jats:italic toggle=\"yes\">Conclusions<\/jats:italic>: Among subjects with NAFLD, sarcopenia is associated with a higher risk of all\u2010cause mortality and liver mortality. Attainment of ideal LS7 metrics provides protection against sarcopenia in NAFLD.<\/jats:p>","DOI":"10.1002\/hep4.2061","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T06:42:44Z","timestamp":1660200164000},"page":"3140-3153","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":30,"title":["Sarcopenia, healthy living, and mortality in patients with chronic liver diseases"],"prefix":"10.1097","volume":"6","author":[{"given":"Catherine","family":"Van Dongen","sequence":"first","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research, Inova Health System,Falls Church,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Paik","sequence":"additional","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research, Inova Health System,Falls Church,Virginia,USA"},{"name":"Center for Liver Disease, Department of Medicine,Inova Fairfax Medical Campus,Falls Church,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Harring","sequence":"additional","affiliation":[{"name":"Center for Liver Disease, Department of Medicine,Inova Fairfax Medical Campus,Falls Church,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef","family":"Younossi","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research in Liver Diseases,Washington,District of Columbia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian K.","family":"Price","sequence":"additional","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research, Inova Health System,Falls Church,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Kabbara","sequence":"additional","affiliation":[{"name":"Center for Liver Disease, Department of Medicine,Inova Fairfax Medical Campus,Falls Church,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9818-0983","authenticated-orcid":false,"given":"Pegah","family":"Golabi","sequence":"additional","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research, Inova Health System,Falls Church,Virginia,USA"},{"name":"Center for Liver Disease, Department of Medicine,Inova Fairfax Medical Campus,Falls Church,Virginia,USA"},{"name":"Inova Medicine, Inova Health System,Falls Church,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9313-577X","authenticated-orcid":false,"given":"Zobair M.","family":"Younossi","sequence":"additional","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research, Inova Health System,Falls Church,Virginia,USA"},{"name":"Center for Liver Disease, Department of Medicine,Inova Fairfax Medical Campus,Falls Church,Virginia,USA"},{"name":"Inova Medicine, Inova Health 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