A Perspective on Metabolic Syndrome and Nonalcoholic Fatty Liver Disease

Abstract

Nonalcoholic fatty liver disease (NAFLD) is increasingly being diagnosed worldwide and is strongly associated with the features of metabolic syndrome. In this brief review, we discuss two key questions relating to NAFLD and metabolic syndrome: (1) Does NAFLD predict the development of type 2 diabetes mellitus and metabolic syndrome, or is it simply an epiphenomenon? (2) Are there differences between metabolic syndrome-associated NAFLD and NAFLD associated with genetic variation in the patatin-like phospholipase domain-containing 3 (PNPLA3) gene? Accumulating evidence indicates that NAFLD is not simply the hepatic manifestation of the metabolic syndrome, but is a pathogenic determinant of the syndrome. Genetic variation within the PNPLA3 gene (e.g., I148M homozygosity) confers a higher risk of developing more severe histological features of NAFLD, but a lower risk of developing metabolic syndrome traits. We suggest that future research is now required to elucidate whether both metabolic syndrome-related NAFLD and PNPLA3-related NAFLD produce the same risk of developing extrahepatic complications.

Prevalence and outcomes of non‐alcoholic fatty liver disease (NAFLD) among Asian American adults in the United States

“…As noted previously, NAFLD is known for its close associations with metabolic syndrome components . As expected, Asian American individuals with NAFLD also had significantly higher rates of obesity, diabetes, hypertension and hyperlipidaemia, all of which are components of metabolic syndrome …”

“…American individuals with NAFLD also had significantly higher rates of obesity, diabetes, hypertension and hyperlipidaemia, all of which are components of metabolic syndrome. [43][44][45] In addition to the prevalence of NAFLD, we estimated the prevalence of advanced fibrosis among both ethnic groups. When we compared the severity of liver fibrosis using noninvasive tools, patients with NAFLD had significantly higher rates of liver fibrosis compared to their controls, but again, the severity of fibrosis seems to be similar between Asian American NAFLD patients with non-Hispanic White NAFLD patients.…”

Data Uncertainty in Virtual Network Embedding: Robust Optimization and Protection Levels

“…Therefore, NAFLD should be considered a multisystem disease affecting several extra-hepatic organs that involves multiple metabolic and endocrine pathways (3).…”

Understanding the association between developing a fatty liver and subsequent cardio-metabolic complications

“…It is plausible to assume that the mechanisms linking NAFLD to T2DM and CVD/cardiac diseases are multifactorial, involve both genetic and acquired factors and often overlap with metabolic disorders, which may frequently coexist in NAFLD patients. However, increasing evidence suggests that, with the exception of cases where NAFLD results from either patatin-like phospholipase domaincontaining 3 (PNPLA3) gene polymorphisms or familial hypobetalipoproteinemia in which NAFLD is usually dissociated from insulin resistance, NAFLD directly causes hepatic insulin resistance in most cases [16,19]. Experimental data indicate that the pathogenetic mechanisms that contribute to intrahepatocytic lipid compartmentation are determinants of whether NAFLD is or is not associated with insulin resistance and T2DM [20].…”

“…Future prospective studies are needed to assess whether the addition of NAFLD to conventional risk factors will improve CVD risk prediction [4]. Finally, more research is also needed to elucidate whether genetic-related NAFLD (e.g., PNPLA3-related NAFLD) carries the same risk as NAFLD occurring with the MetS for the development of both T2DM and CVD/cardiac diseases [19].…”