Nonalcoholic Fatty Liver Disease and Cardiovascular Disease: a Review of Shared Cardiometabolic Risk Factors

Abstract

The prevalence of nonalcoholic fatty liver disease (NAFLD) is rising. NAFLD/nonalcoholic steatohepatitis (NASH) is associated not only with hepatic morbidity and mortality but also with an increased cardiovascular risk. NAFLD and cardiovascular disease (CVD) share several risk factors, such as obesity, metabolic syndrome, hypertension, dyslipidemia, type 2 diabetes, and chronic kidney disease. This review summarizes the evidence linking cardiometabolic risk factors and NAFLD in the context of risk for CVD. The cause of NAFLD/NASH is complex, involving a range of factors from genetics to lifestyle and energy balance. Genetically driven high liver fat content does not appear to be causally associated with increased CVD risk. In contrast, metabolic dysfunction not only predisposes to liver pathology but also leads to a significantly higher CVD risk. Given that NAFLD pathophysiology is influenced by multiple factors, each patient is unique as to their risk of developing CVD and liver pathology. At the same time, the rising burden of NAFLD/NASH is closely linked with the global increase in metabolic disorders, including obesity and type 2 diabetes. Therefore, both personalized therapeutic approaches that recognize individual pathophysiology, as well as public health policies that address the root causes of cardiometabolic risk factors for NAFLD may be needed to effectively address the NAFLD/NASH epidemic.

Effect of Liraglutide on Serum TSH Levels in Patients with NAFLD and its Underlying Mechanisms

“…Collectively, these findings indicate that liraglutide improves hepatic TH resistance in T2DM with NAFLD, and restoration of impaired TRβ expression in NAFLD may be a potential mechanism involved in the process of liraglutide therapy. NAFLD is a serious global health epidemic that causes a growing burden on public health [9]. e accumulation of liver fat, which is most commonly observed in cases of obesity or T2DM, may drive further disease progression [10].…”

Liver Stiffness Is Associated with the Burden of Carotid and Systemic Atherosclerosis in an Unorganized Cohort of Patients 40–64 Years Old

“…The general mechanisms present in the development and progression of NAFLD, liver fibrosis and atherosclerosis are all currently known and continue to be studied [ 43 , 44 ]. It is likely that even in the absence of significant liver fibrosis, hepatic stiffness thresholds can be defined in order to represent the cumulative effect of cardiometabolic risk factors.…”

Distinct impacts of fat and fructose on the liver, muscle, and adipose tissue metabolome: An integrated view

“…The metabolic and homeostatic dysfunctions ( 7 ) caused by the poor lifestyle habits may end up in the onset of hypertension, type 2 diabetes mellitus (T2DM) ( 8 ), cardiovascular disease, dyslipidemia ( 9 ), and non-alcoholic fatty liver disease (NAFLD) ( 10 ). The latter is characterized by the presence of macrovesicular steatosis in ≥5% of hepatocytes, in individuals with no causes for secondary hepatic accumulation, as is the case of abusive alcohol consumption and hereditary disorders ( 11 ).…”