Cardio-Metabolic Disorders in Non-Alcoholic Fatty Liver Disease

Abstract

With the progressive epidemics of obesity, non-alcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease in adults and children. The increasing prevalence and incidence of NAFLD with advanced fibrosis is concerning because patients appear to experience higher non-liver-related morbidity and mortality than the general population. Recent clinical evidence suggests that NAFLD is directly associated with an increased risk of cardio-metabolic disorders. This mini review describes briefly the current understanding of the pathogenesis of NAFLD, summarizing the link between NAFLD and cardio-metabolic complications, focusing mainly upon ischemic stroke, type 2 diabetes mellitus (DM), hypertension, chronic kidney disease (CKD) and cardiac arrhythmias. In addition, it describes briefly the current understanding of the pathogenesis of NAFLD.

Keywords: cardiac arrhythmia; cardio-metabolic disorders; chronic kidney disease; diabetes; dyslipidemia; hypertension; ischemic stroke; non-alcoholic fatty liver disease.

Figure 1

Environmental factors, life style and genetic susceptibility have shown to be implicated in the pathogenesis of visceral obesity and insulin resistance. The metabolic and respiratory complications associated with obesity and insulin resistance as dyslipidemia, OSA (obstructive sleep apnea) Hyperuricemia, hormonal imbalance and systemic low-grade inflammation are established factors in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and progression towards non-alcoholic steatohepatitis (NASH). Remarkably, genetic variation in the patatin-like phospholipase domain-containing protein-3 (PNPLA3) gene is considered a prominent risk factor for progression of liver injury from steatosis to steatohepatitis, cirrhosis and hepatocellular carcinoma (HCC).