Synergistic increase in cardiovascular risk in diabetes mellitus with nonalcoholic fatty liver disease: a meta-analysis

Zhou, Yaoyao; Zhou, Xiaodong; Wu, Shengjie; Hu, Xianqing; Tang, Biao; Poucke, Sven Van; Pan, Xiaoyan; Wu, Wenjun; Gu, Xin; Fu, Shihua; Zheng, Ming‐Hua

doi:10.1097/meg.0000000000001075

Cited by 85 publications

(72 citation statements)

References 34 publications

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“…Indeed, several mechanisms correlated with NAFLD pathogenesis are involved in atherosclerosis and include genetic predisposition, reduced levels of adiponectin, IR, atherogenic dyslipidemia, oxidative stress, chronic inflammation, and altered production of pro- and anti-coagulant factors (Francque et al, 2016). Recently, a systematic review (Zhou et al, 2018) has described a two-fold increase in risk of CVD in diabetic NAFLD patients compared with non-NAFLD group, confirming other previous findings (Targher et al, 2007; Hamaguchi et al, 2007). Likewise, other two independent studies found that TG to high-density lipoprotein cholesterol ratio (TG/HDL-C) could be considered a better NAFLD predictor compared to other several lipid parameters and markers of liver injury (Ren et al, 2019; Fan et al, 2019).…”

Section: Nafld As a Risk Factor For Cardiovascular Diseasessupporting

confidence: 74%

Role of Myeloid-Epithelial-Reproductive Tyrosine Kinase and Macrophage Polarization in the Progression of Atherosclerotic Lesions Associated With Nonalcoholic Fatty Liver Disease

et al. 2019

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Recent lines of evidence highlight the involvement of myeloid-epithelial-reproductive tyrosine kinase (MerTK) in metabolic disease associated with liver damage. MerTK is mainly expressed in anti-inflammatory M2 macrophages where it mediates transcriptional changes including suppression of proinflammatory cytokines and enhancement of inflammatory repressors. MerTK is regulated by metabolic pathways through nuclear sensors including LXRs, PPARs, and RXRs, in response to apoptotic bodies or to other sources of cholesterol. Nonalcoholic fatty liver disease (NAFLD) is one of the most serious public health problems worldwide. It is a clinicopathological syndrome closely related to obesity, insulin resistance, and oxidative stress. It includes a spectrum of conditions ranging from simple steatosis, characterized by hepatic fat accumulation with or without inflammation, to nonalcoholic steatohepatitis (NASH), defined by hepatic fat deposition with hepatocellular damage, inflammation, and accumulating fibrosis. Several studies support an association between NAFLD and the incidence of cardiovascular diseases including atherosclerosis, a major cause of death worldwide. This pathological condition consists in a chronic and progressive inflammatory process in the intimal layer of large- and medium-sized arteries. The complications of advanced atherosclerosis include chronic or acute ischemic damage in the tissue perfused by the affected artery, leading to cellular death. By identifying specific targets influencing lipid metabolism and cardiovascular-related diseases, the present review highlights the role of MerTK in NAFLD-associated atherosclerotic lesions as a potential innovative therapeutic target. Therapeutic advantages might derive from the use of compounds selective for nuclear receptors targeting PPARs rather than LXRs regulating macrophage lipid metabolism and macrophage mediated inflammation, by favoring the expression of MerTK, which mediates an immunoregulatory action with a reduction in inflammation and in atherosclerosis.

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Section: Nafld As a Risk Factor For Cardiovascular Diseasessupporting

confidence: 74%

Role of Myeloid-Epithelial-Reproductive Tyrosine Kinase and Macrophage Polarization in the Progression of Atherosclerotic Lesions Associated With Nonalcoholic Fatty Liver Disease

et al. 2019

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“…Elevations in alanine aminotransferase [70] and gamma glutamyltransferase [71] have been found to predict MetS. Hepatic steatosis is also known to be associated with increased cardiovascular risk including CAD [72], increased coronary artery calcium score [73], atrial fibrillation [74], and overall cardiovascular risk in diabetics [75,76].…”

Section: Eat and Liver Steatosismentioning

confidence: 99%

Epicardial Adipose Tissue: Clinical Biomarker of Cardio-Metabolic Risk

Fricke

Iacobellis

2019

IJMS

131

100

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Epicardial adipose tissue (EAT) is part of the visceral adipose tissue (VAT) that surrounds the heart and it is a quantifiable, modifiable, and multifaceted tissue that has both local and systemic effects. When EAT is enlarged, EAT contributes to atherosclerotic cardiovascular disease (ASCVD) risk and plays a role in the development of metabolic syndrome (MetS). In this review, we will discuss the role of EAT in various facets of MetS, including type 2 diabetes mellitus (T2DM) and insulin resistance. We examine the association between EAT and liver steatosis. We also address the correlations of EAT with HIV therapy and with psoriasis. We discuss racial differences in baseline EAT thickness. We conclude that EAT measurement serves as a powerful potential diagnostic tool in assessing cardiovascular and metabolic risk. Measurement of EAT is made less costly, more convenient, and yet accurate and reliable by transthoracic echocardiography. Furthermore, modification of EAT thickness has therapeutic implications for ASCVD, T2DM, and MetS.

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“…The prevalence of NAFLD among patients with diabetes mellitus (DM) may be as high as 50% . A recent meta‐analysis demonstrated a synergistic increase in cardiovascular mortality among diabetics with NAFLD . In addition, smoking has been shown to be associated with advanced liver fibrosis among NAFLD patients .…”

Section: Introductionmentioning

confidence: 99%

The interaction of nonalcoholic fatty liver disease and smoking on mortality among adults in the United States

Wijarnpreecha

Scribani

Kim

et al. 2019

Liver International

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Background & Aims Nonalcoholic fatty liver disease (NAFLD) has become the most common liver disease in Western countries. Smoking and diabetes mellitus (DM) have been shown to increase mortality; however, whether NAFLD adds to the detrimental effect of smoking in DM and non‐DM patients is unknown. We evaluated the possible interactive effect of NAFLD and smoking on mortality risk in a US population‐based sample. Methods Cross‐sectional data from 11 205 participants in the third National Health and Nutrition Examination Survey were analysed. NAFLD was defined as ultrasonographic hepatic steatosis without evidence of other liver diseases. Proportional hazards regression modelling was used to test for the multiplicative interaction of NAFLD and smoking on overall mortality, controlling for DM. Results 36.5% of the participants had NAFLD of whom 21.1% were current smokers, while among non‐NAFLD subjects, 26.2% reported current smoking. Smoking was associated with a hazard ratio (HR) of 2.23 (95% confidence interval (CI): 1.87‐2.65) among non‐NAFLD subjects, and 2.31 (95% CI: 1.33‐2.92, P < 0.01) among NAFLD patients. In contrast, the HR for NAFLD was 1.01 (95% CI: 0.78‐1.31, P = 0.96) among smokers and 0.98 (95% CI: 0.87‐1.10, P = 0.73) among non‐smokers. There was no evidence of interaction between NAFLD and smoking (HR = 1.01, 95% CI: 0.74‐1.38, P = 0.94) in the combined model. Conclusion We found that smoking increased mortality by two‐fold among the US population. Although the magnitude of the increase in mortality did not differ from that in non‐NAFLD subjects, smoking represents a modifiable determinant of long‐term outcomes in NAFLD patients.

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Synergistic increase in cardiovascular risk in diabetes mellitus with nonalcoholic fatty liver disease: a meta-analysis

Cited by 85 publications

References 34 publications

Role of Myeloid-Epithelial-Reproductive Tyrosine Kinase and Macrophage Polarization in the Progression of Atherosclerotic Lesions Associated With Nonalcoholic Fatty Liver Disease

Role of Myeloid-Epithelial-Reproductive Tyrosine Kinase and Macrophage Polarization in the Progression of Atherosclerotic Lesions Associated With Nonalcoholic Fatty Liver Disease

Epicardial Adipose Tissue: Clinical Biomarker of Cardio-Metabolic Risk

The interaction of nonalcoholic fatty liver disease and smoking on mortality among adults in the United States

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