Review Non-Alcoholic Fatty Liver Disease (NAFLD) and Its Connection with Insulin Resistance, Dyslipidemia, Atherosclerosis and Coronary Heart Disease (original) (raw)
Related papers
Nutrients, 2013
Non-alcoholic fatty liver disease is marked by hepatic fat accumulation not due to alcohol abuse. Several studies have demonstrated that NAFLD is associated with insulin resistance leading to a resistance in the antilipolytic effect of insulin in the adipose tissue with an increase of free fatty acids (FFAs). The increase of FFAs induces mitochondrial dysfunction and development of lipotoxicity. Moreover, in subjects with NAFLD, ectopic fat also accumulates as cardiac and pancreatic fat. In this review we analyzed the mechanisms that relate NAFLD with metabolic syndrome and dyslipidemia and its association with the development and progression of cardiovascular disease.
Non-alcoholic fatty liver disease and insulin resistance: From bench to bedside
Diabetes & Metabolism, 2013
Non-alcoholic fatty liver disease (NAFLD) is now the most frequent chronic liver disease in the developed countries. There is also growing evidence from basic and clinical research that NAFLD has a strong relationship to insulin resistance, which is a key factor in the development of type 2 diabetes. The aim of this review is to summarize the recent important findings linking NAFLD and insulin resistance. Lipid accumulation, particularly of diacylglycerol, appears to be of major importance in this process. Mitochondrial dysfunction, through decreased mitochondrial biogenesis, increases oxidative stress, and ageing also plays an important role. Finally, endoplasmic reticulum stress and inflammation also probably contribute to the development of insulin resistance via mechanisms that are still not well understood. Clinical aspects of NAFLD, such as its diagnosis and management, are also investigated in this review.
Non-alcoholic fatty liver disease (nafld) - a novel common aspect of the metabolic syndrome
Biomedical Papers, 2006
Non-alcoholic fatty liver disease (NAFLD) is emerging as one of the most common liver disorders claiming the urgent attention of both medical professionals and the public sphere because of the imminent epidemic of advanced liver injury that appendages epidemic of obesity. Recent research reveals simple triglyceride accumulation in hepatocytes (i.e., liver steatosis) frequently becoming complicated by inflammation (i.e., non-alcoholic steatohepatitis, or NASH) that may progress into more advanced stages of the disease including cirrhosis or, eventually, hepatocellular carcinoma. The exact mechanisms of the progression of NAFLD into overt NASH and advanced disease stages are largely unknown. There is urgent need in terms of both intensive research pursuits and effective practical measures to deal with this common threat.
The metabolic syndrome and nonalcoholic fatty liver disease
Panminerva medica, 2006
Accumulating evidence supports an association between nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome, diabetes, and obesity. The epidemiology, pathogenesis, and approach to treatment of NAFLD follow the same trends as these other metabolic disorders, and insulin resistance is the key event linking NAFLD to these diseases. The impairment in fat and glucose metabolism that ensues once insulin resistance occurs leads to similar biochemical and clinical abnormalities in patients with NAFLD. Many recent studies investigating the cellular and genetic basis of these diseases have led to a better understanding of their pathogenesis and insight into treatment and management. The most effective treatment thus far is weight loss and the use of insulin-modulating pharmacologic agents. A few additional treatment strategies include the use of lipid-lowering, antioxidants or cytoprotective agents, but there is no single therapeutic approach that is effective for managing NAFLD. Fu...
Journal of Gastroenterology and Hepatology Research, 2019
Currently in the world, thousands of people are somewhat overweight. Obesity, mainly characterized by the accumulation of fat in adipose tissue can cause various damages in the body, incluind Metabolic Syndrome. There is a high correlation between patients with this syndrome and those with Non-Alcoholic Fatty Liver Disease (NAFLD), being defined as the increase of the deposition of lipids in the liver in the absence of excessive consumption of alcohol. Excess intake of saturated fatty acids, increased free fatty acids derived from white adipose tissue lipolysis, reduced β-oxidation along with an increase in de novo lipogenesis and decreased synthesis or secretion of VLDL in hepatocytes contribute to the Hepatic steatosis. The treatment for these pathologies is initially based on diet changes and physical activity practice. In addition, there are still some classes of medicines available to treat the accumulation of fat in the liver as well as decrease insulin resistance. Studies still seek to find specific medicines for the treatment of NAFLD, therefore, the most effective method continues to be prevention, through an improvement in the quality of life, related to a balanced diet and the practice of regular physical activity.
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD.
The Role of Lipid and Lipoprotein Metabolism in Non‐Alcoholic Fatty Liver Disease
Children
Due to the epidemic of obesity across the world, nonalcoholic fatty liver disease (NAFLD) has become one of the most prevalent chronic liver disorders in children and adolescents. NAFLD comprises a spectrum of fat-associated liver conditions that can result in end-stage liver disease and the need for liver transplantation. Simple steatosis, or fatty liver, occurs early in NAFLD and may progress to nonalcoholic steatohepatitis, fibrosis and cirrhosis with increased risk of hepatocellular carcinoma. The mechanism of the liver injury in NAFLD is currently thought to be a "multiple-hit process" where the first "hit" is an increase in liver fat, followed by multiple additional factors that trigger the inflammatory activity. At the onset of disease, NAFLD is characterized by hepatic triglyceride accumulation and insulin resistance. Liver fat accumulation is associated with increased lipotoxicity from high levels of free fatty acids, free cholesterol and other lipid metabolites. As a consequence, mitochondrial dysfunction with oxidative stress and production of reactive oxygen species and endoplasmic reticulum stress-associated mechanisms, are activated. The present review focuses on the relationship between intra-cellular lipid accumulation and insulin resistance, as well as on lipid and lipoprotein metabolism in NAFLD.
The role of hepatic fat accumulation in pathogenesis of non-alcoholic fatty liver disease (NAFLD
Lipids in health and disease, 2010
Nonalcoholic fatty liver disease is increasingly regarded as a hepatic manifestation of metabolic syndrome, and the severity of nonalcoholic fatty liver disease seems to increase in parallel with other features of metabolic syndrome. Excess lipid accumulation in the liver cells is not only a mediator of Metabolic Syndrome and indicator of a lipid overload but also accompanied by a range of histological alterations varying from 'simple' steatosis to nonalcoholic steatohepatitis, with time progressing to manifest cirrhosis. Hepatocellular carcinoma may also occur in nonalcoholic steatohepatitis -related cirrhosis with a mortality rate similar to or worse than for cirrhosis associated with hepatitis C. This review summarizes the knowledge about the causal relationship between hepatic fat accumulation, insulin resistance, liver damage and the etiological role of hepatic fat accumulation in pathogenesis of extra-and intra-hepatic manifestations. Special emphasis is given suggestions of new targets treatment and prevention of nonalcoholic fatty liver disease.
Non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease: An open question
Nutrition, Metabolism and Cardiovascular Diseases, 2007
Aims: To review available data concerning the basic science and epidemiological-clinical evidence for an association of NAFLD and cardiovascular disease. Data synthesis: Non-alcoholic fatty liver disease (NAFLD) defines alcohol-like hepatic histological lesions seen in the non-alcoholic, insulin resistant patient representing the hepatic counterpart of the metabolic syndrome. Along with insulin resistance, additional genetic, endocrine and vascular changes together with environmental stimulidwhich are also involved in the pathogenesis of atherosclerosisdplay a prominent role in the development and progression of NAFLD. Clinical and epidemiological studies seem to indicate that NAFLD is associated with an increased risk for cardiovascular disease but further studies are needed to confirm the available data. The mainstay of NAFLD treatment is based on the correction of the same metabolic changes that predispose to atherosclerosis. Conclusions: Non-invasive evaluation of risk for cardiovascular events is recommended in all individuals presenting with NAFLD and conversely, the presence Abbreviations: MS, metabolic syndrome; T2DM, type 2 diabetes mellitus; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; IR, insulin resistance; GH, growth hormone; CRP, C-reactive protein; PPAR-gamma, peroxisome proliferator-activated receptor gamma; UCP-2, uncoupling protein-2. www.elsevier.com/locate/nmcd of NAFLD should always be looked for in subjects with features belonging to the metabolic syndrome. Further studies are needed on the mechanisms linking fatty liver and vascular diseases. ª