Nonalcoholic fatty liver disease - A multisystem disease?

Abstract

Non-alcoholic fatty liver disease (NAFLD) is one of the most common comorbidities associated with overweight and metabolic syndrome (MetS). Importantly, NAFLD is one of its most dangerous complications because it can lead to severe liver pathologies, including fibrosis, cirrhosis and hepatic cellular carcinoma. Given the increasing worldwide prevalence of obesity, NAFLD has become the most common cause of chronic liver disease and therefore is a major global health problem. Currently, NAFLD is predominantly regarded as a hepatic manifestation of MetS. However, accumulating evidence indicates that the effects of NAFLD extend beyond the liver and are negatively associated with a range of chronic diseases, most notably cardiovascular disease (CVD), diabetes mellitus type 2 (T2DM) and chronic kidney disease (CKD). It is becoming increasingly clear that these diseases are the result of the same underlying pathophysiological processes associated with MetS, such as insulin resistance, chronic systemic inflammation and dyslipidemia. As a result, they have been shown to be independent reciprocal risk factors. In addition, recent data have shown that NAFLD actively contributes to aggravation of the pathophysiology of CVD, T2DM, and CKD, as well as several other pathologies. Thus, NAFLD is a direct cause of many chronic diseases associated with MetS, and better detection and treatment of fatty liver disease is therefore urgently needed. As non-invasive screening methods for liver disease become increasingly available, detection and treatment of NAFLD in patients with MetS should therefore be considered by both (sub-) specialists and primary care physicians.

Regression of Non-Alcoholic Fatty Liver by Metabolic Reduction: Phototherapy in Association with Aerobic Plus Resistance Training In Obese Man - A Pilot Study

“…In addition, the reduction of the visceral fat (Table 1) is directly related to the decrease in basal insulin (Figure 1), factors that have already been correlated in the literature [5,6,12]. In our study, it was possible to verify the reduction of basal insulin when the values of the phototherapy group were compared with the control.…”

“…The process unleashed by physical inactivity and inadequate feeding, over time, causes changes in body composition that lead to the development of diseases and comorbidities associated with them [6,9,29,30]. In this way, the excess of fat, dyslipidemias and insulin resistance can promote the accumulation of fat in the liver, known as non-alcoholic fatty liver disease [4,31].…”

“…In this context, as attributed in experimental work [18], the association between moderate intensity exercise and phototherapy promoted an increase in hepatic glycogen concentration and a consequent decrease in liver fat. The high concentration of liver fat is a long-term cause of non-alcoholic hepatic steatosis and cancer [5,6].…”

“…In the same context, according to the literature [5], individuals in the range of body mass index established as obese of degree I, already have a high degree of possibility, about 80%, to develop fat in the liver. The chronic development of this alteration can result in severe inflammatory process, generating posterior consequences, like non-alcoholic steatohepatitis (NASH), fibrosis and cancer [6].…”

Non-alcoholic fatty liver disease, bulb carotid intima-media thickness and obesity phenotypes: results of a prospective observational study

“…Obesity and ab-dominal obesity, metabolic syndrome, and type 2 diabetes have been identified among risk factors for NAFLD [10], which in turn is associated with an increased risk of fatal and non-fatal CV events and increased risk of total and CV diseases mortality [11]. The gold standard for NAFLD diagnosis is the liver biopsy but its invasive nature limits its use.…”