Nonalcoholic fatty liver disease (NAFLD), the most common of chronic liver disease in Western Country, is closely related to insulin resistance and oxidative stress and includes a wide spectrum of liver diseases ranging from steatosis alone, usually a benign and non-progressive condition, to nonalcoholic steatohepatitis (NASH), which may progress to liver fibrosis and cirrhosis. NAFLD is considered the hepatic manifestation of the metabolic syndrome with which shares several characteristics, however recent data suggest that NAFLD is linked to increased cardiovascular risk independently of the broad spectrum of risk factors of metabolic syndrome. Accumulating evidence suggests that the clinical burden of NAFLD is not restricted to liver-related morbidity and mortality, with the majority of deaths in NAFLD patients related to cardiovascular disease and cancer and not to the progression of liver disease. Retrospective and prospective studies provide evidence of a strong association between NAFLD and subclinical manifestation of atherosclerosis (increased intima-media thickness, endothelial dysfunction, arterial stiffness, impaired left ventricular function and coronary calcification). A general agreement emerging from these studies indicates that patients with NASH are at higher risk of cardiovascular diseases than those with simple steatosis, emphasizing the role of chronic inflammation in the pathogenesis of atherosclerosis of these patients. It is very likely that the different mechanisms involved in the pathogenesis of atherosclerosis in patients with NAFLD have a different relevance in the patients according to individual genetic background. In conclusion, in the presence of NAFLD patients should undergo a complete cardiovascular evaluation to prevent future atherosclerotic complications. Specific life-style modification and aggressive pharmaceutical modification will not only reduce the progression of liver disease, but also reduce morbidity for cardiovascular disease improving overall prognosis and survival.
Nonalcoholic fatty liver disease and vascular disease: state-of-the-art.
S. Fargion,M. Porzio,A. Fracanzani
Published 2014 in World Journal of Gastroenterology
ABSTRACT
PUBLICATION RECORD
- Publication year
2014
- Venue
World Journal of Gastroenterology
- Publication date
2014-10-07
- Fields of study
Medicine, Environmental Science
- Identifiers
- External record
- Source metadata
Semantic Scholar, PubMed
CITATION MAP
EXTRACTION MAP
CLAIMS
CONCEPTS
- atherosclerosis
A vascular disease process involving plaque buildup and arterial wall changes in blood vessels.
- cardiovascular disease
Diseases of the heart and blood vessels that are used here as the main non-liver clinical outcome associated with NAFLD.
Aliases: CVD
- chronic inflammation
Persistent inflammatory activity that can contribute to vascular injury and atherosclerotic progression.
- metabolic syndrome
A cluster of metabolic abnormalities that commonly co-occur, including insulin resistance, obesity, dyslipidemia, and hypertension.
- nonalcoholic fatty liver disease
A chronic liver disease characterized by excess fat accumulation in the liver in the absence of significant alcohol use.
Aliases: NAFLD
- nonalcoholic steatohepatitis
An inflammatory form of nonalcoholic fatty liver disease that includes liver injury in addition to fat accumulation.
Aliases: NASH
- subclinical atherosclerosis
Early vascular abnormalities detectable by imaging or functional measures before overt cardiovascular events occur.