Non-alcoholic Fatty Liver Disease and Metabolic Syndrome—Position Paper of the Indian National Association for the Study of the Liver, Endocrine Society of India, Indian College of Cardiology and Indian Society of Gastroenterology

Abstract

Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context.

Ovaries are more vulnerable than hepatocytes for insulin resistance and hyperinsulinemia

“…This study showed that metabolic abnormalities are common findings in patients with NAFLD and PCOS, as reported previously (21). However, our study also showed that metabolic abnormalities were more severely and more frequently expressed in the NAFLD patients than in the PCOS patients.…”

Comparison of the Phenotype and Approach to Pediatric vs Adult Patients With Nonalcoholic Fatty Liver Disease

“…77,78 For example, Ekstedt et al 79 , showed an increased risk of death from cardiovascular disease in a cohort of adult patients with biopsy-proven NAFLD.…”

Prevalence of Nonalcoholic - Fatty Liver Disease in Metabolic Syndrome - A Hospital-Based Cross-Sectional Study

“…They suggested that weight reduction might prove helpful in reversing the pathology of NAFLD in Type 2 diabetes. A position paper published by the combined effort of Indian National Association for study of the liver, Endocrine Society of India, Indian College of Cardiology and Indian Society of Gastroenetrology gives the detail description about the association of NAFLD and metabolic syndrome in Indian population and recommended a multidisciplinary approach involving hepatologist, internists, cardiologist and also endocrinologists for the proper management of NAFLD [15]. Diehl in his article emphasizes the impact of fatty liver disease on hepatic complications such as fibrosis, cirrhosis, and even carcinoma [16].…”