Nonalcoholic fatty liver disease and the renin-angiotensin system: Implications for treatment

Paschos, Paschalis; Τζιόμαλος, Κωνσταντίνος

doi:10.4254/wjh.v4.i12.327

Cited by 85 publications

(67 citation statements)

References 33 publications

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“…In clinical practice, however, the usefulness of treating liver fibrosis with ARBs remains contradictory (Schneider et al, 1999;Gonzalez-Abraldes et al, 2001;Lee, 2014). A handful of randomized controlled trials suggest that ARB treatment is a potentially useful therapeutic approach in patients with nonalcoholic fatty liver disease (Paschos and Tziomalos, 2012). The nonalcoholic fatty liver disease patients benefited from telmisartan and olmesartan treatment (Enjoji et al, 2008;Colmenero et al, 2009).…”

Section: G Pathophysiological Aspects Of Angii Type 1 Receptor Activmentioning

confidence: 99%

International Union of Basic and Clinical Pharmacology. XCIX. Angiotensin Receptors: Interpreters of Pathophysiological Angiotensinergic Stimuli

et al. 2015

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Section: G Pathophysiological Aspects Of Angii Type 1 Receptor Activmentioning

confidence: 99%

International Union of Basic and Clinical Pharmacology. XCIX. Angiotensin Receptors: Interpreters of Pathophysiological Angiotensinergic Stimuli

et al. 2015

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“…Moreover, observational studies suggest that patients with NAFLD have increased cardiovascular risk and that CVD is the leading cause of death in this population [10][11][12][13] . Since NAFLD and CVD have many common risk factors (e.g., abdominal obesity, type 2 diabetes mellitus (T2DM), insulin resistance, inflammation and oxidative stress), the increased CVD risk in patients with NAFLD might be partly explained by their shared pathogenesis [14][15][16][17] . However, there is increased CVD risk in patients with NAFLD even in the absence of T2DM, suggesting that NAFLD is directly causative of CVD [18] .…”

Section: Introductionmentioning

confidence: 99%

Lipid-lowering agents in the management of nonalcoholic fatty liver disease

Τζιόμαλος¹

2014

WJH

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Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in developed countries and is associated not only with increased risk for liver disease-related complications but also with higher cardiovascular morbidity. Accordingly, lipid-lowering agents are frequently considered in these patients to reduce cardiovascular risk. However, there have been concerns regarding the safety of these agents in patients with chronic liver diseases. In the present review, we discuss the safety of lipid-lowering agents in patients with NAFLD as well as their effects on both cardiovascular and liver disease in this population. Accumulating data suggest that statins are safe in patients with NAFLD and that they reduce the increased cardiovascular morbidity of this population. However, it is still unclear whether statins are also useful as a treatment for NAFLD per se , since there are very limited and conflicting data on their effects on liver histology. There is also very scarce evidence regarding the safety and efficacy of other lipid-lowering agents in patients with NAFLD. Randomized controlled studies are needed to evaluate the role of lipid-lowering agents and particularly statins for the prevention of both cardiovascular and liver disease-related complications in this high-risk population. Core tip: Accumulating data suggest that statins are safe in patients with nonalcoholic fatty liver disease (NAFLD) and that they reduce the increased cardiovascular morbidity of this population. However, it is still unclear whether statins are also useful as a treatment for NAFLD per se , since there are very limited and conflicting data on their effects on liver histology. There is also very scarce evidence regarding the safety and efficacy of other lipid-lowering agents in patients with NAFLD.Tziomalos K. Lipid-lowering agents in the management of nonalcoholic fatty liver disease.

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“…Nevertheless, increasing evidence indicates that low-grade chronic inflammation may be the cause of several conditions and diseases associated with obesity, including type-2 diabetes, cardiovascular diseases, and fatty liver disease (Paschos and Tziomalos, 2012). In the previous chapter, it was demonstrated that hens treated with E 2 showed an increased inflammatory response as demonstrated by changes in peripheral blood (elevated leukocyte numbers and fibrinogen levels) and structural alterations of liver tissue.…”

Section: Clinical Biochemistrymentioning

confidence: 99%

Fatty Liver Haemorrhagic Syndrome in Laying Hens: Field and Experimental Investigations

Shini¹

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Field and experimental investigations were conducted to study the fatty liver haemorrhagic syndrome (FLHS) in caged laying hens. The main goal of the research was to gain a greater understanding of the aetiology and pathogenesis of this non-infectious disease. The disease is characterized by excessive accumulation of fat in the liver and abdominal cavity, subsequent liver rupture, haemorrhage and sudden death of hens. It has been shown that the balance between hepatic synthesis and secretion of lipids is the key point that regulates hepatic and extrahepatic fat deposition in hens. Liver fat accumulation can be increased by many factors, especially nutrition, housing conditions, and inflammatory challenges. A description of normal and abnormal lipid metabolism in the hen, and consequences for hen health and disease (including FLHS) is given in the literature review (Chapter 2).The initial study examined mortality of layer flocks kept in three different housing systems (cage, barn and free range) on the Gatton Campus, University of Queensland (Chapter 4). It was shown that there were no significant differences in mortality rates of hens (6.1%, 6.4% and 5.8%, for cages, barns and free range, respectively) between the housing systems but the causes of death were different. The most common cause of death in hens kept in cages was FLHS with 74% of dead hens dying from the condition. In contrast, FLHS only accounted for 0 to 5% of hen mortality in the other systems. Post-mortem of dead hens and body weight monitoring of flocks throughout the laying cycle were recommended as tools to predict FLHS.An epidemiological survey (Chapter 5) of caged flocks in South-Eastern Queensland was undertaken to explore the prevalence of FLHS in commercial layer flocks. From necropsies of dead birds from 7 flocks of different ages, it was found that approximately 40% of hens died due to FLHS. This result indicated that FLHS continues to be the major cause of mortality in commercial caged laying hens kept in either controlled environment sheds or naturally ventilated sheds. As part of the epidemiological study, a questionnaire was circulated among farms and the responses revealed that there is a general lack of knowledge of FLHS in the industry.The study of the pathogenesis of FLHS is very difficult as it occurs sporadically and over an extended period of time in the field. In the studies in Chapter 6, an oestradiol (E 2 ) hen model was used to study the condition. The administration of exogenous E 2 reproduced the disease in 30 wk old laying hens, and was associated with significant changes in E 2 plasma levels and metabolic iv profiles, increased liver weights, and macroscopic (fat depositions, haemorrhages and haematomas) and microscopic alterations. Hens exposed to E 2 and fed ad libitum diet experienced severe FLHS and had a higher incidence of FLHS than hens that had their feed intake restricted by 10%. One interesting observation from this study (not reported from other investigators) was the alteration of total leukocyte n...

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Nonalcoholic fatty liver disease and the renin-angiotensin system: Implications for treatment

Cited by 85 publications

References 33 publications

International Union of Basic and Clinical Pharmacology. XCIX. Angiotensin Receptors: Interpreters of Pathophysiological Angiotensinergic Stimuli

International Union of Basic and Clinical Pharmacology. XCIX. Angiotensin Receptors: Interpreters of Pathophysiological Angiotensinergic Stimuli

Lipid-lowering agents in the management of nonalcoholic fatty liver disease

Fatty Liver Haemorrhagic Syndrome in Laying Hens: Field and Experimental Investigations

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