REVIEW article
Front. Endocrinol.
Sec. Bone Research
Osteosarcopenia in Metabolic Dysfunction–Associated Steatotic Liver Disease: From Mechanisms to Management
Provisionally accepted
- 1Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
- 2Institute of Hepatobiliary Disease, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
- 3Nankai University Affiliated Third Center Hospital, Tianjin, China
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Osteosarcopenia, the coexistence of osteoporosis and sarcopenia, is an emerging and underrecognized complication in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). While muscle and bone loss have been individually observed in MASLD, their combined impact remains poorly addressed in clinical practice. This review outlines the epidemiology, pathophysiological mechanisms, clinical relevance, and current strategies for diagnosing and managing osteosarcopenia in MASLD. Shared pathogenic pathways, including insulin resistance, chronic inflammation, hormonal imbalance, and gut dysbiosis, create a vicious cycle contributing to musculoskeletal degradation and liver disease progression. We highlight the need for proactive screening of osteosarcopenia, and using standardized assessment tools. A multidimensional therapeutic approach, encompassing nutrition, exercise, pharmacotherapy, and emerging metabolic and gut-targeted interventions, may improve not only musculoskeletal health but also hepatic and systemic outcomes. Future studies are warranted to improve long-term prognosis for both osteosarcopenia and MASLD.
Keywords: osteosarcopenia, Osteoporosis, Sarcopenia, Metabolic Dysfunction – AssociatedSteatotic Liver Disease, Mechanism, Management
Received: 15 Sep 2025; Accepted: 26 Nov 2025.
Copyright: © 2025 Ye, Fan and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qing Ye
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