Endocrine and liver interaction: the role of endocrine pathways in NASH

Loria, Paola; Carulli, Lucia; Bertolotti, Marco; Lonardo, Amedeo

doi:10.1038/nrgastro.2009.33

Cited by 142 publications

(127 citation statements)

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“…Patients with short bowel syndrome also develop NAFLD/NASH due to severe malnutrition. Many endocrine diseases such as hypothyroidism, hypopituitarism, hypogonadism, and polycystic ovary syndrome are risk factors for the development of NAFLD/ NASH [39][40][41][42][43]. These endocrine diseases can lead to obesity, insulin resistance, and/or dyslipidemia, which can in turn result in NAFLD.…”

Section: Clinical Featuresmentioning

confidence: 99%

Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

et al. 2015

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Nonalcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease in industrialized countries worldwide, and has become a serious public health issue not only in Western countries but also in many Asian countries including Japan. Within the wide spectrum of NAFLD, nonalcoholic steatohepatitis (NASH) is a progressive form of disease, which often develops into liver cirrhosis and increases the risk of hepatocellular carcinoma. In turn, a large proportion of NAFLD/NASH is the liver manifestation of metabolic syndrome, suggesting that NAFLD/NASH plays a key role in the pathogenesis of systemic atherosclerotic diseases. Currently, a definite diagnosis of NASH requires liver biopsy, though various noninvasive measures are under development. The mainstays of prevention and treatment of NAFLD/NASH include dietary restriction and exercise; however, pharmacological approaches are often necessary.Currently, vitamin E and thiazolidinedione derivatives are the most evidence-based therapeutic options, although the clinical evidence for long-term efficacy and safety is limited. This practice guideline for NAFLD/NASH, established by the Japanese Society of Gastroenterology in cooperation with The Japan Society of Hepatology, covers lines of clinical evidence reported internationally in the period starting from 1983 to January 2012, and each clinical question was evaluated using the GRADE system. Based on the primary release of the full version in Japanese, this English summary provides the core essentials of this clinical practice guideline comprising the definition, diagnosis, and current therapeutic recommendations for NAFLD/NASH in Japan.

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Section: Clinical Featuresmentioning

confidence: 99%

Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

et al. 2015

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“…Various mechanisms have been proposed, including increased oxidative stress, inflammation, hepatocellular apoptosis and fibrogenesis [17,29,30] . There is accumulating evidence that oxidative stress and mitochondrial dysfunction are relevant in the pathogenesis of steatohepatitis, whatever its initial cause [31,32] .…”

Section: Steatohepatitis and Fibrosismentioning

confidence: 99%

Pediatric non-alcoholic fatty liver disease: Preventive andtherapeutic value of lifestyle intervention

Nobili¹,

Alisi²,

Raponi³

2009

WJG

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Nonalcoholic fatty liver disease (NAFLD), ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), and eventually cirrhosis and liver failure, is seen to be increasing amongst Western children. NAFLD rates are rising in parallel with the epidemic of childhood obesity, and in particular, fatty liver evolves more easily in NASH when poor dietary habits and sedentary lifestyle are combined. In fact, its general prevalence in the child population varies between 2.6% and 10%, but increases up to 80% in obese children. Since NASH is expected to become the most common cause of pediatric chronic liver disease in the near future, there is broad interest amongst clinical researchers to move forward, both in diagnosis and treatment. Unfortunately, to date, the expensive and invasive procedure of liver biopsy is seen as the gold standard for NASH diagnosis and few noninvasive diagnostic methods can be applied successfully. Moreover, there are still no approved pharmacological interventions for NAFLD/NASH. Therefore, current management paradigms are based upon the presence of associated risk factors and aims to improve an individual's quality of life, thus reducing NAFLD-associated morbidity and mortality. Today, lifestyle intervention (diet and exercise) is the treatment of choice for NAFLD/ NASH. Thus far, no study has evaluated the potential preventive effect of lifestyle intervention on children at risk of NAFLD/NASH. Future studies will be required in this area with the perspective of developing a national program to promote nutrition education and increase physical activity as means of preventing the disease in individuals at risk. Here, we outline the clinical course, pathogenesis and management of NAFLD in children, highlighting the preventive and therapeutic value of lifestyle intervention.

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“…The increase in triglycerides in patients with hypothyroidism is explained by the reduced hepatic activity of triglyceride lipase (48,50) and increased fatty acid oxidation. Loria et al come to the conclusion that hepatic steatosis may develop from hypothyroidism induced hyperlipidemia and overweight (51). The development of hepatic steatosis may be explained by an increase influx of triglycerides and an imbalance between the inand outflow of other lipids in the liver.…”

Section: Discussionmentioning

confidence: 99%

Association and impact of non-alcoholic fatty liver disease on thyroid function

2017

Int. J. Curr. Res. Med. Sci.

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Nonalcoholic fatty liver disease (NAFLD) means accumulation of fat mainly triglyceride exceeding 5 % of liver weight, affecting approximately 20% of population in developed countries. Thyroid dysfunction have been frequently associated with non-alcoholic fatty liver disease. The aim of this study is to determine any association between nonalcoholic fatty liver disease and thyroid dysfunction and to evaluate the impact of non-alcoholic fatty liver disease on thyroid function tests. Subjects and methods: This study was carried out on sixty adult men and women with nonalcoholic fatty liver disease and sixty age-and sex-matched males and females without the disease. NAFLD patients were subjected to a full assessment of medical history, physical examination, abdominal ultrasonography as well as routine laboratory tests. Patients and controls underwent liver function and thyroid function testing including thyroid antibodies. Results: Thirteen patients with NAFLD (21.7%) were found to have thyroid dysfunction. The most common thyroid dysfunction was subclinical hypothyroidism which was found in 10 (16.7%) NAFLD patients followed by overt hypothyroidism in 3 patients (5%). There were statistically significant difference between patients and controls as regard to TSH (p=0.0001), FT4 (p=0.005), FT3 (P=0.043), anti-TPO (p=0.047), anti-TG (p=0.001), IR (p=0.024), insulin (p=0.002), and Leptin (p=0.002). TSH concentration was significantly correlated with ALT (r= 0.381), GGT (r=0.354), HbA1C (r=0.288), triglyceride (r=0.368), FT4 (r=0.414), FT3(r=0.231), anti-TPO(r=0.298), serum insulin (r= 0.287), insulin resistance (IR) (r= 0.453), and serum Leptin (r=0.360) levels.In our patients, hepatic steatosis in the form of increased liver echogenecity was present in almost all patients (100%), and hepatomegaly in twenty-four patients (40%). Thus. Hepatic steatosis were correlated significantly with ALT, GGT, HbA1C, triglyceride, HDL-C, TSH, FT4, FT3, anti-TPO, anti-TG, serum insulin, insulin resistance (IR), and serum Leptin. Conclusion: Thyroid dysfunctions are common in NAFLD patients, with subclinical hypothyroidism hypothyroidism being the most prevalent one. Hepatic steatosis has shown an evident positive correlation with elevated TSH as well as thyroid autoantibodies.

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Endocrine and liver interaction: the role of endocrine pathways in NASH

Cited by 142 publications

References 114 publications

Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

Pediatric non-alcoholic fatty liver disease: Preventive andtherapeutic value of lifestyle intervention

Association and impact of non-alcoholic fatty liver disease on thyroid function

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