{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T02:58:57Z","timestamp":1771210737730,"version":"3.50.1"},"reference-count":97,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sci"],"abstract":"<jats:p>Background and aim: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD) affects up to 25% of the population and causes significant morbidity and mortality. Sarcopenia, the loss of muscle strength and quantity\/quality, shares multiple pathways with MASLD, pointing to their possible association. In this systematic review, we aimed to describe the association between low muscle mass and\/or strength and\/or performance and the presence, development, or severity of MASLD\/NAFLD. Methods: A search was performed in PubMed, Web of Science, Scopus, and LILACS, on 16 October 2020, for relevant studies, using a comprehensive search query and following PRISMA guidelines for systematic review conduction and reporting. Results: The search yielded 1042 results, of which 42 full papers and 11 poster abstracts were included. NAFLD was determined by imaging (n = 27), non-invasive tests (n = 13), liver biopsy (n = 11), or transient elastography (n = 2), and its severity by liver biopsy (n = 10), non-invasive tests (n = 7), transient elastography (n = 7), or imaging (n = 4). Muscle mass was, in most cases, adjusted for weight (n = 25), body mass index (BMI; n = 13), or height (n = 10). Most studies showed an association of low muscle mass and low strength with NAFLD presence and severity. However, the association of muscle mass with NAFLD was present when muscle mass was adjusted for weight or BMI but not when it was adjusted for height. A meta-analysis was not possible due to high heterogeneity in the methods of assessment of muscle parameters and NAFLD. Conclusions: This systematic review suggests the need for standardization of methods in this discipline. The issuing of specific guidance regarding sarcopenia in NAFLD would be of importance.<\/jats:p>","DOI":"10.3390\/sci6040059","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T05:26:33Z","timestamp":1727760393000},"page":"59","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["How Sarcopenia, Muscle Mass, Strength, and Performance Relate to Non-Alcoholic Fatty Liver Disease: A Systematic Review"],"prefix":"10.3390","volume":"6","author":[{"given":"Joana","family":"Rigor","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Unidade Local de Sa\u00fade da P\u00f3voa de Varzim\/Vila do Conde, 4480-733 Vila do Conde, Portugal"},{"name":"Rede de Investiga\u00e7\u00e3o em Sa\u00fade (RISE-UFP), Fernando Pessoa University, 4249-004 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4586-2910","authenticated-orcid":false,"given":"Matilde","family":"Monteiro-Soares","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, 4200-319 Porto, Portugal"},{"name":"Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine of the University of Porto, 4200-319 Porto, Portugal"},{"name":"Escola Superior de Sa\u00fade da Cruz Vermelha Portuguesa\u2013Lisboa, 1300-125 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4537-5450","authenticated-orcid":false,"given":"Pedro","family":"Barata","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Fernando Pessoa University, 4200-150 Porto, Portugal"},{"name":"Pathology Department, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, 4099-001 Porto, Portugal"},{"name":"Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade (I3S), University of Porto, 4200-135 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9709-9948","authenticated-orcid":false,"given":"Daniela","family":"Martins-Mendes","sequence":"additional","affiliation":[{"name":"Rede de Investiga\u00e7\u00e3o em Sa\u00fade (RISE-UFP), Fernando Pessoa University, 4249-004 Porto, Portugal"},{"name":"School of Medicine and Biomedical Sciences, Fernando Pessoa University, 4249-004 Porto, Portugal"},{"name":"Instituto de Investiga\u00e7\u00e3o, Inova\u00e7\u00e3o e Desenvolvimento Fernando Pessoa (FP-I3ID), Biomedical Health Sciences, Fernando Pessoa University, 4249-004 Porto, Portugal"},{"name":"Biomedical Department, Faculty of Medicine of the University of Porto, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1111\/jgh.15799","article-title":"Validation of five hepatic steatosis algorithms in metabolic-associated fatty liver disease: A population based study","volume":"37","author":"Liu","year":"2022","journal-title":"J. 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