Investigating Myosteatosis in Steatotic Liver Diseases

This project investigates the correlation between liver and muscle phenotypes assessed in a cohort of all 3 SLD subgroups (MASLD, ALD and MetALD). If a severe form of SLD is suspected based on a severely increased liver elasticity, assessed by transient elastography, participants undergo a liver biopsy, liver and muscle magnetic resonance imaging. Eating habits and physical activity level are recorded using the 24 hour-recall and international physical activity questionnaire. Psychological disorders are also screened using dedicated questionnaires.

Inclusion criteria

• Age between18 to 75 years
• Presence of hepatic steatosis, suggested by a controlled attenuation parameter (CAP) ≥ 252 dB/m on elastometry and elevated transaminases (ALT ≥ 25 or 33 IU/L in women or men respectively)
• Presence of overweight (BMI > 25 kg/m²), obesity (BMI > 30 kg/m²), metabolic syndrome, prediabetes or type 2 diabetes. Metabolic syndrome is defined by int ernational Diabetes Federation as follows : waist circumference ≥ 94/80cm for men/women with ≥ 2 other criteria: arterial pressure ≥ 130/85 mmHg or treatment for hypertension, fasting glucose ≥ 130/85 mmHg or treatment for hypertension, serum triglycerides > 150 mg/dl or treatment for dyslipidemia, HDL cholesterol < 40/50 mg/dl for men/women or treatment for dyslipidemia.

Exclusion criteria

• Liver disease from other causes (alcohol, active viral chronic hepatitis B or C, Wilson's disease, autoimmune hepatitis, alpha1-anti-trypsin deficiency,...)
• Heavy consumption of alcoholic beverages, i.e. > 140 g or 210 g of ethanol in women or men respectively).
• Intravenous drug use
• HbA1C > 10%
• Decompensated cirrhosis (presence of ascites, bilirubin level > 1.2 mg/dL in a patient without Gilbert's syndrome, albumin level < 35 g/L)
• Pregnancy
• Use of drugs that may cause steatosis (methotrexate, amiodarone, tamoxifen, oral corticosteroids) currently or in the last 3 months
• Change in treatment of hyperglycaemia (dose or medication) in the last 3 months
• Change in body weight >5% in the last 3 months
• Active cancer
• End stage renal disease or dialysis
• Type 1 diabetes or secondary diabetes
• Digestive malabsorption
• Untreated thyroid disease
• Taking a treatment under study or approved for NASH (semaglutide, lanifibranor, obeticholic acid).
• Musculoskeletal disorders, neuromuscular or inflammatory diseases such as connective tissue diseases, myositis and vasculitis that have musculoskeletal manifestations.