Non-alcoholic fatty liver disease, metabolic syndrome and subclinical cardiovascular changes in the general population

Kim, Nan Hee; Park, Juri; Kim, Seong Hwan; Kim, Yong Hyun; Kim, Dong Hyuk; Cho, Goo Yeong; Baik, Inkyung; Lim, Hong Euy; Kim, Eung Ju; Na, Jin Oh; Lee, Jung Bok; Lee, Seung Ku; Shin, Chol

doi:10.1136/heartjnl-2013-305099

Cited by 85 publications

(76 citation statements)

References 29 publications

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“…On multivariate analysis only early diastolic velocity, assessed on tissue Doppler imaging was found to be associated with NAFLD. This has also been found by other centers [35][36][37][38][39][40][41] . Furthermore this may be an early consequence of NAFLD.…”

Section: Nafld and Left Ventricular Functionsupporting

confidence: 85%

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Non-alcoholic fatty liver disease - the heart of the matter

Azzam

Malnick

2015

WJH

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Non-alcoholic fatty liver disease (NAFLD) is one of the most common forms of chronic liver disease in the Western world. There is a close association with the metabolic syndrome and NAFLD is considered to be the hepatic manifestation of the metabolic syndrome. The components of the metabolic syndrome include hypertension, obesity and insulin resistance which are well established cardiovascular risk factors. The mortality rate of NAFLD patients from myocardial infarction is higher than that in the general United States population and there is also an increased risk of nonfatal cardiovascular events. This article reviews the cardiovascular complications associated with NAFLD. In order to provide comprehensive care of NAFLD patients, physicians need to be aware of, and search for, the cardiac morbidity associated with NAFLD. Core tip: Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Due to the overlapping cardiovascular risk factors in the metabolic syndrome, there are cardiovascular consequences linked to the presence of NAFLD in a patient. We review these complications and also a less well appreciated complication of diastolic dysfunction that is intimately associated with NAFLD. Physicians looking after NAFLD patients need to be aware of these complications and actively search for and treat them.Azzam H, Malnick S. Non-alcoholic fatty liver disease -the heart of the matter. World J Hepatol 2015; 7(10):

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Section: Nafld and Left Ventricular Functionsupporting

confidence: 85%

“…32 patients (64%) with NAFLD, compared to other 18 patients. TT echo and TDI performed Early features of LV diastolic dysfunction may be detected in patients with type 2 diabetes and NAFLD Kim et al [38] 1886 participants without CVS disease. Stratified by the presence or absence of CT-diagnosed NAFLD, MetS.…”

Section: Ref Methods Resultsmentioning

confidence: 99%

Non-alcoholic fatty liver disease - the heart of the matter

Azzam

Malnick

2015

WJH

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“…US-defined NAFLD carries a 1.5-to 2-fold adjusted risk of incident CKD in type 1 diabetes mellitus [80]. NAFLD is also associated with colorectal cancer [81], metabolic bone disease (vitamin D deficiency, osteoporosis) [62,82] and rare metabolic diseases (lipodystrophies, glycogen storage diseases).…”

Section: Other Extrahepatic Disordersmentioning

confidence: 99%

EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease

2016

Diabetologia

501

248

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“…Although NAFLD has been considered as the hepatic manifestation of the metabolic syndrome, evidence has shown that NAFLD is associated with cardiovascular morbidity and mortality independently of metabolic syndrome. Therefore, other than pro-cirrhotic, NAFLD had to be considered an important modifiable risk factor for cardiovascular diseases [8].As a result of the high clinical impact of NAFLD in the general population, treatment of NAFLD is essential. However, despite promising studies have been conducted with several agents, so far no strong evidence supports a specific pharmacological treatment.…”

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confidence: 99%

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confidence: 99%

Omega-3 Polyunsaturated Fatty Acids in the Treatment of Non-Alcoholic Fatty Liver Disease: Are They So Good?

Colussi¹,

Soardo²,

Fagotto³

et al. 2017

J Metabolic Synd

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EditorialNon-alcoholic fatty liver disease (NAFLD) is the most prevalent hepatic problem in Western and Asian countries where it can affect more than 30% of people [1]. NAFLD pathological characteristic is a fat infiltration of the hepatocytes (hepatic steatosis) in subjects who are mild or no alcohol drinkers and do not have other secondary causes of hepatic lipid accumulation. In one fifth of affected patients, NAFLD can evolve in a liver inflammatory damage, which is associated with oxidative stress, cytolysis, and fibrosis (steatohepatitis) [2]. Of these patients, more than one-third progress to liver cirrhosis and a small part can develop hepatocarcinoma along years. It's not clear why some patients with NAFLD evolve to non-alcoholic steatohepatitis (NASH) while others remain stable over years, though a role of intestinal inflammation, gut dysbiosis, and hypovitaminosis D has been recently proposed [3]. Consistently, subjects at high risk to develop NAFLD are those affected by obesity, type 2 diabetes mellitus, and other conditions associated with insulin resistance or hyperinsulinemia such as hypertension, dyslipidemia, polycystic ovary disease, and metabolic syndrome, as well as patients with chronic inflammatory bowel diseases [4]. Patients with NAFLD are characterized by increased circulatory levels of triglycerides and free fatty acids (FFAs) that come from the adipose tissue through the lipolytic process, from the hepatic lipid de-novo synthesis, and to a minor extent from food intake. Both insulin resistance and hyperinsulinemia in predisposed subjects are associated with a visceral fat distribution and are responsible for the high level of circulatory FFAs [5]. FFAs enter and accumulate in insulin-resistant hepatocytes and by esterification with glycerol increase hepatic triglycerides synthesis and very low-density lipoproteins (VLDL) production; thus, favoring hypertriglyceridemia. The overflow of plasma lipids and lipid metabolites in non-adipose tissues induces "lipotoxicity", a pathological process characterized by lipids accumulation in liver and in other organs such as heart, kidney, pancreas, and skeletal muscle [6]. This process is responsible for the development and progression of heart and kidney failure, obesity, and diabetes, as well as for the systemic release of inflammatory cytokines. System cytokines maintain chronic subclinical inflammation, induce oxidative stress and endothelial dysfunction, and predispose to the atherosclerotic process [7]. Although NAFLD has been considered as the hepatic manifestation of the metabolic syndrome, evidence has shown that NAFLD is associated with cardiovascular morbidity and mortality independently of metabolic syndrome. Therefore, other than pro-cirrhotic, NAFLD had to be considered an important modifiable risk factor for cardiovascular diseases [8].As a result of the high clinical impact of NAFLD in the general population, treatment of NAFLD is essential. However, despite promising studies have been conducted with several agents, so far no strong...

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Non-alcoholic fatty liver disease, metabolic syndrome and subclinical cardiovascular changes in the general population

Abstract: NAFLD was associated with early alterations of cardiovascular system, independent of established cardiovascular risk factors and MetS.

Cited by 85 publications

References 29 publications

Non-alcoholic fatty liver disease - the heart of the matter

Non-alcoholic fatty liver disease - the heart of the matter

EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease

Omega-3 Polyunsaturated Fatty Acids in the Treatment of Non-Alcoholic Fatty Liver Disease: Are They So Good?

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