Myosteatosis in NAFLD patients correlates with plasma Cathepsin D

Lingling Ding, Toon J I De Munck, Yvonne Oligschlaeger, Inês Magro Dos Reis, Jef Verbeek, Ger H Koek, Tom Houben, Ronit Shiri-Sverdlov*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Previously, we have shown that hepatic lipid accumulation induces the secretion of cathepsin D (CTSD), and that plasma CTSD levels are associated with increased inflammation and disease severity in nonalcoholic fatty liver disease (NAFLD). Although it is clear that the liver is a major source of plasma CTSD, it is unknown whether other metabolically active organs such as the muscle, also associate with plasma CTSD levels in NAFLD patients. Therefore, the aim of this study was to explore the relation between lipid accumulation in the muscle (myosteatosis) and plasma CTSD levels in forty-five NAFLD patients. We observed that hepatic steatosis positively associated with plasma CTSD levels, confirming the previously established link between plasma CTSD and the liver. Furthermore, a positive association between myosteatosis and plasma CTSD levels was observed, which was independent of sex, age, BMI, waist circumference and hepatic steatosis. By establishing a positive association between myosteatosis and plasma CTSD levels, our findings suggest that, in addition to the liver, the muscle is also linked to plasma CTSD levels in NAFLD patients. The observed link between myosteatosis and plasma CTSD levels supports the concept of a significant role of the skeletal muscle in metabolic disturbances in metabolic syndrome-related disorders.

Original languageEnglish
Pages (from-to)27-35
Number of pages9
JournalBiomolecular Concepts
Issue number1
Publication statusPublished - 15 May 2021


  • Adult
  • Aged
  • Cathepsin D/blood
  • Female
  • Fibrosis/blood
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal/metabolism
  • Non-alcoholic Fatty Liver Disease/physiopathology
  • Sarcopenia/blood
  • Young Adult

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