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Review
. 2015 Jan-Mar;4(1):45-52.
doi: 10.4103/2249-4863.152252.

Nonalcoholic Fatty liver disease and risk of diabetes and cardiovascular disease: what is important for primary care physicians?

Affiliations
Review

Nonalcoholic Fatty liver disease and risk of diabetes and cardiovascular disease: what is important for primary care physicians?

Mohamed H Ahmed et al. J Family Med Prim Care. 2015 Jan-Mar.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common chronic liver condition in Western World and across the globe. NAFLD prevalence is estimated to be around one-third of the total population. There are no published data that project the future prevalence of NAFLD, but with an increase in epidemic of diabetes and obesity, it is possible to suggest an increase in a number of individuals with NAFLD. NAFLD is associated with insulin resistance and occurs with an increase in cluster of features of metabolic syndrome and type 2 diabetes. Therefore, it is important to exclude the possibility of diabetes in those individuals with evidence of fatty liver. The global diabetes epidemic continues to grow, and it is estimated that the number of people with diabetes will double by year 2030. NAFLD is also a risk factor for an increase in cardiovascular incidence independent of age, sex, low-density lipoprotein-cholesterol, smoking, and cluster of metabolic syndromes. It is expected that NAFLD will be an important challenge for health providers in the near future. Taking all these factors into consideration, we believe that increasing awareness of metabolic and cardiovascular impact of NAFLD among general practitioners and health authorities may decrease the serious consequences of late diagnosis of NAFLD. Importantly, the collaboration between medical specialties is vital in decreasing the impact of the epidemic of NAFLD. The focus of this review is in the role of primary care physician in diagnosis, treatment and prevention of NAFLD and patients education.

Keywords: Cardiovascular disease; insulin resistance; nonalcoholic fatty liver disease; primary care physician; type 2 diabetes mellitus.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Conditions associated with nonalcoholic fatty liver disease (NAFLD) and factors that lead to nonalcoholic steatohepatits
Figure 2
Figure 2
Schematic figure showing possible pathways involved in the pathogenesis of nonalcoholic fatty liver disease
Figure 3
Figure 3
Possible algorithm for management of nonalcoholic fatty liver disease in primary health care

References

    1. Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology. 1999;30:1356–62. - PubMed
    1. Loria P, Adinolfi LE, Bellentani S, Bugianesi E, Grieco A, Fargion S, et al. Practice guidelines for the diagnosis and management of nonalcoholic fatty liver disease. A decalogue from the Italian Association for the Study of the Liver (AISF) Expert Committee. Dig Liver Dis. 2010;42:272–82. - PubMed
    1. Ahmed MH. Biochemical markers: The road map for the diagnosis of nonalcoholic fatty liver disease. Am J Clin Pathol. 2007;127:20–2. - PubMed
    1. Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, et al. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med. 1999;107:450–5. - PubMed
    1. Ahmed MH, Byrne CD. UK: Wiley-Blackwell; 2011. Non-Alcoholic Fatty Liver Disease in the Metabolic Syndrome; pp. 245–77.