Cargando…

Sarcopenia: Ammonia metabolism and hepatic encephalopathy

Sarcopenia (loss of muscle mass and/or strength) frequently complicates liver cirrhosis and adversely affects the quality of life; cirrhosis related liver decompensation and significantly decreases wait-list and post-liver transplantation survival. The main therapeutic strategies to improve or rever...

Descripción completa

Detalles Bibliográficos
Autores principales: Jindal, Ankur, Jagdish, Rakesh Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association for the Study of the Liver 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759436/
https://www.ncbi.nlm.nih.gov/pubmed/31006226
http://dx.doi.org/10.3350/cmh.2019.0015
_version_ 1783453686577496064
author Jindal, Ankur
Jagdish, Rakesh Kumar
author_facet Jindal, Ankur
Jagdish, Rakesh Kumar
author_sort Jindal, Ankur
collection PubMed
description Sarcopenia (loss of muscle mass and/or strength) frequently complicates liver cirrhosis and adversely affects the quality of life; cirrhosis related liver decompensation and significantly decreases wait-list and post-liver transplantation survival. The main therapeutic strategies to improve or reverse sarcopenia include dietary interventions (supplemental calorie and protein intake), increased physical activity (supervised resistance and endurance exercises), hormonal therapy (testosterone), and ammonia lowering agents (L-ornithine L-aspartate, branch chain amino acids) as well as mechanistic approaches that target underlying molecular and metabolic abnormalities. Besides other factors, hyperammonemia has recently gained attention and increase sarcopenia by various mechanisms including increased expression of myostatin, increased phosphorylation of eukaryotic initiation factor 2a, cataplerosis of α ketoglutarate, mitochondrial dysfunction, increased reactive oxygen species that decrease protein synthesis and increased autophagy-mediated proteolysis. Sarcopenia contributes to frailty and increases the risk of minimal and overt hepatic encephalopathy.
format Online
Article
Text
id pubmed-6759436
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher The Korean Association for the Study of the Liver
record_format MEDLINE/PubMed
spelling pubmed-67594362019-10-02 Sarcopenia: Ammonia metabolism and hepatic encephalopathy Jindal, Ankur Jagdish, Rakesh Kumar Clin Mol Hepatol Review Sarcopenia (loss of muscle mass and/or strength) frequently complicates liver cirrhosis and adversely affects the quality of life; cirrhosis related liver decompensation and significantly decreases wait-list and post-liver transplantation survival. The main therapeutic strategies to improve or reverse sarcopenia include dietary interventions (supplemental calorie and protein intake), increased physical activity (supervised resistance and endurance exercises), hormonal therapy (testosterone), and ammonia lowering agents (L-ornithine L-aspartate, branch chain amino acids) as well as mechanistic approaches that target underlying molecular and metabolic abnormalities. Besides other factors, hyperammonemia has recently gained attention and increase sarcopenia by various mechanisms including increased expression of myostatin, increased phosphorylation of eukaryotic initiation factor 2a, cataplerosis of α ketoglutarate, mitochondrial dysfunction, increased reactive oxygen species that decrease protein synthesis and increased autophagy-mediated proteolysis. Sarcopenia contributes to frailty and increases the risk of minimal and overt hepatic encephalopathy. The Korean Association for the Study of the Liver 2019-09 2019-04-22 /pmc/articles/PMC6759436/ /pubmed/31006226 http://dx.doi.org/10.3350/cmh.2019.0015 Text en Copyright © 2019 by The Korean Association for the Study of the Liver This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Jindal, Ankur
Jagdish, Rakesh Kumar
Sarcopenia: Ammonia metabolism and hepatic encephalopathy
title Sarcopenia: Ammonia metabolism and hepatic encephalopathy
title_full Sarcopenia: Ammonia metabolism and hepatic encephalopathy
title_fullStr Sarcopenia: Ammonia metabolism and hepatic encephalopathy
title_full_unstemmed Sarcopenia: Ammonia metabolism and hepatic encephalopathy
title_short Sarcopenia: Ammonia metabolism and hepatic encephalopathy
title_sort sarcopenia: ammonia metabolism and hepatic encephalopathy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759436/
https://www.ncbi.nlm.nih.gov/pubmed/31006226
http://dx.doi.org/10.3350/cmh.2019.0015
work_keys_str_mv AT jindalankur sarcopeniaammoniametabolismandhepaticencephalopathy
AT jagdishrakeshkumar sarcopeniaammoniametabolismandhepaticencephalopathy