{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:01:49Z","timestamp":1791849709244,"version":"4.3.4"},"reference-count":67,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T00:00:00Z","timestamp":1649030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["HGY-164788"],"award-info":[{"award-number":["HGY-164788"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000010","name":"Canadian Association for the Study of the Liver","doi-asserted-by":"publisher","award":["HGY-164788"],"award-info":[{"award-number":["HGY-164788"]}],"id":[{"id":"10.13039\/501100000010","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000264","name":"Canadian Liver Foundation","doi-asserted-by":"publisher","award":["HGY-164788"],"award-info":[{"award-number":["HGY-164788"]}],"id":[{"id":"10.13039\/501100000264","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Myosteatosis, or pathological excess fat accumulation in muscle, has been widely defined as a lower mean skeletal muscle radiodensity on computed tomography (CT). It is reported in more than half of patients with cirrhosis, and preliminary studies have shown a possible association with reduced survival and increased risk of portal hypertension complications. Despite the clinical implications in cirrhosis, a standardized definition for myosteatosis has not yet been established. Currently, little data exist on the mechanisms by which excess lipid accumulates within the muscle in individuals with cirrhosis. Hyperammonemia may play an important role in the pathophysiology of myosteatosis in this setting. Insulin resistance, impaired mitochondrial oxidative phosphorylation, diminished lipid oxidation in muscle and age-related differentiation of muscle stem cells into adipocytes have been also been suggested as potential mechanisms contributing to myosteatosis. The metabolic consequence of ammonia-lowering treatments and omega-3 polyunsaturated fatty acids in reversing myosteatosis in cirrhosis remains uncertain. Factors including the population of interest, design and sample size, single\/combined treatment, dosing and duration of treatment are important considerations for future trials aiming to prevent or treat myosteatosis in individuals with cirrhosis.<\/jats:p>","DOI":"10.3390\/cells11071216","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T09:49:41Z","timestamp":1649065781000},"page":"1216","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Myosteatosis in Cirrhosis: A Review of Diagnosis, Pathophysiological Mechanisms and Potential Interventions"],"prefix":"10.3390","volume":"11","author":[{"given":"Maryam","family":"Ebadi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology & Liver Unit, University of Alberta, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Tsien","sequence":"additional","affiliation":[{"name":"Ajmera Transplant Program, Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9088-8848","authenticated-orcid":false,"given":"Rahima A.","family":"Bhanji","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Liver Unit, University of Alberta, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abha R.","family":"Dunichand-Hoedl","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition, University of Alberta, Edmonton, AB T6G 2P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elora","family":"Rider","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Liver Unit, University of Alberta, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Motamedrad","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition, University of Alberta, Edmonton, AB T6G 2P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera C.","family":"Mazurak","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition, University of Alberta, Edmonton, AB T6G 2P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9609-1001","authenticated-orcid":false,"given":"Vickie","family":"Baracos","sequence":"additional","affiliation":[{"name":"Department of Oncology, Cross Cancer Institute, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2511-7980","authenticated-orcid":false,"given":"Aldo J.","family":"Montano-Loza","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Liver Unit, University of Alberta, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1111\/apt.15927","article-title":"Review article: Prognostic significance of body composition abnormalities in patients with cirrhosis","volume":"52","author":"Ebadi","year":"2020","journal-title":"Aliment. 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