Nonalcoholic Fatty Liver Disease: Focus on New Biomarkers and Lifestyle Interventions

Abstract

Nonalcoholic fatty liver disease (NAFLD) is considered a hepatic manifestation of metabolic syndrome, characterized from pathological changes in lipid and carbohydrate metabolism. Its main characteristics are excessive lipid accumulation and oxidative stress, which create a lipotoxic environment in hepatocytes leading to liver injury. Recently, many studies have focused on the identification of the genetic and epigenetic modifications that also contribute to NAFLD pathogenesis and their prognostic implications. The present review is aimed to discuss on cellular and metabolic alterations associated with NAFLD, which can be helpful to identify new noninvasive biomarkers. The identification of accumulated lipids in the cell membranes, as well as circulating cytokeratins and exosomes, provides new insights in understanding of NAFLD. This review also suggests that lifestyle modifications remain the main prevention and/or treatment for NAFLD.

Lipid peroxidation as a hallmark of severity in COVID-19 patients

“…Kang R et al [ 35 ] described that lipid peroxidation in ferroptosis induces pyroptosis, suggesting a link between ferroptosis and other forms of cell death in sepsis. Lipid peroxidation is involved in several disease conditions [ 36 ] like cardiovascular disease [ 37 ] cancer [ 38 ], Alzheimer [ 39 ] and chronic diseases such as NAFLD [ 40 ], Multiple Sclerosis [ 41 ], COPD [ 42 ] and Diabetes mellitus [ 43 ].…”

Role of Oxidative Stress and Lipid Peroxidation in the Pathophysiology of NAFLD

“…Although NASH CRN does not exactly define NASH by using the NASH score [ 24 ], we determined NASH according to the NASH score of ≥ 4 (with at least 1 point each in inflammation and ballooning) [ 25 ]. This threshold was based on the inclusion criteria of most of the Food and Drug Administration (FDA)-approved clinical trials to develop NAFLD therapeutic drugs [ 26 ]. Clinical characteristics of patients are shown in Table 1 .…”

“…NAFLD has been considered a complex disease, which is also frequently associated with other pathologies such as diabetes and cardiovascular and chronic kidney diseases [ 26 ]. Multiple studies have revealed that NAFLD is a hepatic manifestation of metabolic syndrome, characterised by pathological changes in carbohydrate and lipid metabolism [ 27 , 28 ].…”

“…In NAFLD, the increased lipid storage into the hepatocytes induces the production of high levels of reactive oxygen species (ROS), which leads to LPO [ 26 ]. LPO is a biological free radical chain reaction.…”

Exosomal FZD-7 Expression Is Modulated by Different Lifestyle Interventions in Patients with NAFLD

“…Exosomes, which are well recognized active cell–cell communicators, are produced not only from parenchymal cells but also from non-parenchymal cells; it has been proven that they are able to deliver their bioactive cargo from cell of origin to recipient cells. In the literature, their relevant involvement in NAFLD disease progression and degeneration has been extensively documented, as they promote inflammation [ 12 , 13 , 14 , 15 ].…”