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Review
. 2024 May 9:19:e03.
doi: 10.15420/ecr.2023.26. eCollection 2024.

Navigating the Link Between Non-alcoholic Fatty Liver Disease/Non-alcoholic Steatohepatitis and Cardiometabolic Syndrome

Sheila Gato  1   2 , Vanessa García-Fernández  1 , Antonio Gil-Gómez  1   2 , Ángela Rojas  1   2 , Rocío Montero-Vallejo  1   2 , Rocío Muñoz-Hernández  1   2   3 , Manuel Romero-Gómez  1   2   4   5
Affiliations
Review

Navigating the Link Between Non-alcoholic Fatty Liver Disease/Non-alcoholic Steatohepatitis and Cardiometabolic Syndrome

Sheila Gato et al. Eur Cardiol. .

Abstract

The global prevalence of non-alcoholic fatty liver disease (NAFLD) is nearly 25% and is increasing rapidly. The spectrum of liver damage in NAFLD ranges from simple steatosis to non-alcoholic steatohepatitis, characterised by the presence of lobular inflammation and hepatocyte ballooning degeneration, with or without fibrosis, which can further develop into cirrhosis and hepatocellular carcinoma. Not only is NAFLD a progressive liver disease, but numerous pieces of evidence also point to extrahepatic consequences. Accumulating evidence suggests that patients with NAFLD are also at increased risk of cardiovascular disease (CVD); in fact, CVDs are the most common cause of mortality in patients with NAFLD. Obesity, type 2 diabetes and higher levels of LDL are common risk factors in both NAFLD and CVD; however, how NAFLD affects the development and progression of CVD remains elusive. In this review, we comprehensively summarise current data on the key extrahepatic manifestations of NAFLD, emphasising the possible link between NAFLD and CVD, including the role of proprotein convertase substilisin/kenin type 9, extracellular vesicles, microbiota, and genetic factors.

Keywords: Non-alcoholic fatty liver disease (NAFLD); cardiovascular disease (CVD); extracellular vesicles; genetics; microbiota.

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Conflict of interest statement

Disclosures: MRG has received grants from Andalucía se mueve con Europa, Instituto de Salud Carlos III, Gilead, Intercept and Siemens; consulting fees from Abbvie, Alpha-sigma, Allergan, AstraZeneca, Axcella, BMS, Boehringer-Ingelheim, Gilead, Inventia, Kaleido, MSD, Novo-Nordisk, Pfizer and Proscientol; honoraria from Inventia, Novo-Nordisk, Rubió, Shionogi and Sobi; travel support from Abbvie and Gilead; and participates on an advisory board for Galmed. All other authors have no conflicts of interest to declare. Funding: This work was supported by Instituto de Salud Carlos III: PFIS FI20/00201 to SGZ, IFI22/00035 to VGF, Sara Borrell CD23-00024 to AGG; Junta de Andalucía: Talento Doctores DOC_00866 to RMH and Instituto de Salud Carlos III: PMP21/00078 and PI22/01342 to MRG.

Figures

Figure 1:
Figure 1:. Mechanisms Potentially Responsible for Endothelial Dysfunction and Atherosclerosis in Non-alcoholic Fatty Liver Disease
Figure 2:
Figure 2:. Possible Effects of Proprotein Convertase Subtilisin/Kexin Type 9 on Non-alcoholic Fatty Liver Disease and Related Cardiovascular Disease
See this image and copyright information in PMC

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References

    1. European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL–EASD–EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64:1388–402. doi: 10.1016/j.jhep.2015.11.004. - DOI - PubMed
    1. Powell EE, Wong VW, Rinella M. Non-alcoholic fatty liver disease. Lancet. 2021;397:2212–24. doi: 10.1016/S0140-6736(20)32511-3. - DOI - PubMed
    1. Younossi Z, Anstee QM, Marietti M et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15:11–20. doi: 10.1038/nrgastro.2017.109. - DOI - PubMed
    1. Charlton MR, Burns JM, Pedersen RA et al. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology. 2011;141:1249–53. doi: 10.1053/j.gastro.2011.06.061. - DOI - PubMed
    1. Ballestri S, Zona S, Targher G et al. Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review and meta-analysis. J Gastroenterol Hepatol. 2016;31:936–44. doi: 10.1111/jgh.13264. - DOI - PubMed

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