Association Between Metabolic Dysfunction-Associated Steatotic Liver Disease and Sarcopenia: A Systematic Review and Meta-analysis
Abstract
This systematic review and meta-analysis evaluated the prevalence of sarcopenia in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) compared to controls. A comprehensive search across PubMed, Embase, Cochrane Library, and Web of Science databases was conducted from January 2015 to August 2025, identifying studies that compared the prevalence of sarcopenia between MASLD patients and non-MASLD controls. Sixteen studies comprising diverse populations from Korea, China, the United States, Italy, the Netherlands, and the United Kingdom were included, with sample sizes ranging from 57 to 18,815 participants. Sarcopenia assessment methods varied across studies, including dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), computed tomography (CT), and functional tests. Statistical analyses were performed using RevMan 5.4 (The Cochrane Collaboration, London, England, UK) with random-effects models to calculate pooled odds ratios (ORs). The meta-analysis revealed a significantly higher prevalence of sarcopenia in MASLD patients (14.86%) compared to controls (6.49%), with a pooled OR of 2.24 (95% CI: 1.74-2.89, p < 0.001). Substantial heterogeneity was observed (I² = 95%) across studies. Subgroup analyses demonstrated stronger associations in cohort studies versus cross-sectional studies, in populations under 50 years of age, and in studies from Korea and the United States. The bidirectional relationship between MASLD and…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 18,815 participants or records.
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