Nonalcoholic fatty liver disease: Updates in noninvasive diagnosis and correlation with cardiovascular disease

Abstract

Nonalcoholic fatty liver disease (NAFLD) refers to the accumulation of fat (mainly triglycerides) within hepatocytes. Approximately 20%-30% of adults in the general population in developed countries have NAFLD; this trend is increasing because of the pandemicity of obesity and diabetes, and is becoming a serious public health burden. Twenty percent of individuals with NAFLD develop chronic hepatic inflammation [nonalcoholic steatohepatitis (NASH)], which can be associated with the development of cirrhosis, portal hypertension, and hepatocellular carcinoma in a minority of patients. And thus, the detection and diagnosis of NAFLD is important for general practitioners. Liver biopsy is the gold standard for diagnosing NAFLD and confirming the presence of NASH. However, the invasiveness of this procedure limits its application to screening the general population or patients with contraindications for liver biopsy. The development of noninvasive diagnostic methods for NAFLD is of paramount importance. This review focuses on the updates of noninvasive diagnosis of NAFLD. Besides, we review clinical evidence supporting a strong association between NAFLD and the risk of cardiovascular disease because of the cross link between these two disorders.

Effects of Green Coffee Bean Extract Supplementation on Patients with Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial

“…The increasing prevalence of NAFLD is tied to the rising epidemic of obesity (2), and now it is affecting approximately one third of the population in the developed countries and Asia (3). The prevalence of NAFLD in the obese population is estimated to be as high as 60%, and NASH is diagnosed in 19% of these individuals (4).…”

Can FIB4 and NAFLD fibrosis scores help endocrinologists refer patients with non-alcoholic fat liver disease to a hepatologist?

“…Diagnosis of this condition will therefore be more important for endocrinologists and for public health systems (6) as it may increase direct and indirect health costs (7), generate referrals to specialists (12) and alter morbidity and mortality of patients, due to increased risk of cardiovascular events (25,26), and progression of the liver disease (27). Hepatocellular carcinoma rates are expected to increase in the future (28,29), and NAFLD is predicted to be the main reason for liver transplants in 2020 (27).…”

Cardiovascular Disease and NASH

“…6 Several evidences support the association of NAFLD/NASH and the occurrence of cardiovascular events, such as increased carotid intima-media thickness, increased coronary artery calcification, impaired flow-mediated vasodilatation and arterial stiffness independent of traditional risk factors and MetS. [7][8][9] The finding that NAFLD is associated with an increased risk of Atrial Fibrillation (AF) in people without evidence of co-existing valvular heart disease supports the assertion that NAFLD may also be an emerging risk factor for cardiac arrhythmias. 10,11 Another marker of early coronary atherosclerosis is association of NAFLD and increased Coronary Artery Calcium (CAC) score on cardiac Computed Tomography (CT).…”