ResearchArticle Frailty in Nonalcoholic Fatty Liver Cirrhosis: A Comparison with Alcoholic Cirrhosis, Risk Patterns, and Impact on Prognosis Lubomir Skladany , 1 Pavol Molcan , 1 Jana Vnencakova, 1 Petra Vrbova , 2 Michal Kukla , 3 Lukas Laffers , 4 and Tomas Koller 2 1 Department of Hepatology, Gastroenterology, and Transplantation (HEGITO), 2 nd Department of Medicine, Slovak Medical University, FD Roosevelt Faculty Hospital, N´ am. L. Svobodu 1, Banska Bystrica 97517, Slovakia 2 Gastroenterology and Hepatology Subdivision, 5 th Department of Medicine, Comenius University Faculty of Medicine, University Hospital Bratislava, Ruzinovska 6, Bratislava 82606, Slovakia 3 Department of Internal Medicine and Geriatrics and Department of Endoscopy, Jagiellonian University Medical College and University Hospital in Cracow, Jakubowskiego 2, Krak´ ow 30-688, Poland 4 DepartmentofMathematics,FacultyofNaturalSciences,MatejBelUniversity,Tajovsk´eho40,Bansk´ aBystrica97401,Slovakia Correspondence should be addressed to Tomas Koller; tomas.koller@fmed.uniba.sk Received 24 February 2021; Accepted 3 May 2021; Published 21 May 2021 Academic Editor: Branka Filipovi´ c Copyright © 2021 Lubomir Skladany et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Physical frailty increases susceptibility to stressors and predicts adverse outcomes of cirrhosis. Data on disease course in different etiologies are scarce, so we aimed to compare the prevalence and risk factors of frailty and its impact on prognosis in nonalcoholic fatty liver (NAFLD) and alcoholic (ALD) cirrhosis. PatientsandMethods. Cirrhosis registry RH7 operates since 2014 and includes hospitalized patients with decompensated cirrhosis, pre-LTevaluation, or curable hepatocellular carcinoma (HCC). From the RH7, we identified 280 ALD and 105 NAFLD patients with at least 6 months of follow-up. Results. Patients with NAFLD compared with ALD were older and had a higher proportion of females, higher body mass index (BMI) and mid-arm cir- cumference (MAC), lower MELD score, CRP, and lower proportion of refractory ascites. e liver frailty index did not differ, and the prevalence of HCC was higher (17.1 vs. 6.8%, p � 0.002). Age, sex, serum albumin, and C-reactive protein (CRP) were independent predictors of frailty. In NAFLD, frailty was also associated with BMI and MAC and in ALD, with the MELD score. e Cox model adjusted for age, sex, MELD, CRP, HCC, and LFI showed that NAFLD patients had higher all-cause mortality (HR � 1.88 95% CI 1.32–2.67, p < 0.001) and were more sensitive to the increase in LFI (HR � 1.51, 95% CI 1.05–2.2). Conclusion. Patients with NAFLD cirrhosis had a comparable prevalence of frailty compared to ALD. Although prognostic indices showed less advanced disease, NAFLD patients were more sensitive to frailty, which reflected their higher overall disease burden and led to higher all-cause mortality. 1. Introduction Pandemics of inactivity and sarcopenic obesity rapidly in- crease the global burden of NAFLD [1, 2], which is estimated at 25% and is expected to increase substantially until 2030 [3, 4]. To attract more attention of the general public, it has been recently proposed to rename nonalcoholic fatty liver disease (NAFLD) to “metabolic-associated fatty liver dis- ease” (MAFLD) [5, 6]. Slovakia, with 349 cases of decom- pensated advanced chronic liver disease (ACLD) per 100,000 inhabitants, ranks number one in the world. e leading cause is alcoholic liver disease (ALD), and the fastest- growing cause is NAFLD [7]. Sarcopenia in NAFLD com- pared to other cirrhosis etiologies lies higher upstream in the disease pathophysiology. Several reports have highlighted the negative impact of sarcopenia in NAFLD and ACLD [8–19]. Although diagnosing sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP2) consensus is indispensable in academic re- search, it is less convenient in real-life hepatology practice Hindawi Canadian Journal of Gastroenterology and Hepatology Volume 2021, Article ID 5576531, 10 pages https://doi.org/10.1155/2021/5576531