Metabolic syndrome and risk factors for non-alcoholic fatty liver disease

Abstract

-Context -Non-alcoholic fatty liver disease (NAFLD), hepatic manifestation of metabolic syndrome, has been considered the most common liver disease nowadays, which is also the most frequent cause of elevated transaminases and cryptogenic cirrhosis. The greatest input of fatty acids into the liver and consequent increased beta-oxidation contribute to the formation of free radicals, release of inflammatory cytokines and varying degrees of hepatocytic aggression, whose histological expression may vary from steatosis (HS) to non-alcoholic steatohepatitis (NASH). The differentiation of these forms is required by the potential risk of progression to cirrhosis and development of hepatocellular carcinoma. Objective -To review the literature about the major risk factors for NAFLD in the context of metabolic syndrome, focusing on underlying mechanisms and prevention. Method -PubMed, MEDLINE and SciELO data basis analysis was performed to identify studies describing the link between risk factors for metabolic syndrome and NAFLD. A combination of descriptors was used, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, metabolic syndrome and risk factors. At the end, 96 clinical and experimental studies, cohorts, meta-analysis and systematic reviews of great impact and scientific relevance to the topic, were selected. Results -The final analysis of all these data, pointed out the central obesity, type 2 diabetes, dyslipidemia and hypertension as the best risk factors related to NAFLD. However, other factors were highlighted, such as gender differences, ethnicity, genetic factors and the role of innate immunity system. How these additional factors may be involved in the installation, progression and disease prognosis is discussed. Conclusion -Risk factors for NAFLD in the context of metabolic syndrome expands the prospects to 1) recognize patients with metabolic syndrome at high risk for NAFLD, 2) elucidate pathways common to other co-morbidities, 3) determine risk factors associated with a worse prognosis, 4) develop therapeutic strategies with goal of reducing risk factors, 5) apply acquired knowledge in public health policies focusing on preventive strategies. HEADINGS -Metabolic syndrome X. Fatty liver, non-alcoholic. Risk factors.

Nonalcoholic Fatty Liver Disease in Patients With Coronary Disease From a Brazil Northeast Area

“…Some parameters such as the presence of diabetes mellitus (DM), overweight, obesity, insulin resistance (IR), and liver enzyme abnormalities may suggest the existence of NAFLD (12,22,24) . Coronary artery disease (CAD) and they have been associated with the severity, progression and mortality in patients with NAFLD.…”

A Novel Mouse Model of Combined Hyperlipidemia Associated With Steatosis and Liver Injury by a Single-Dose Intragastric Administration of Schisandrin B/Cholesterol/Bile Salts Mixture

“…Due to their association with atherosclerosis, hyper lipidemia constitutes one of the major risk factors for vascular diseases such as coronary artery disease, a leading cause of death in developed countries, as well as hepatic steatosis (1,2). Fatty liver-induced steatohepatitis, a specific pattern of injury within the spectrum of nonalcoholic fatty liver disease, can gradually lead to the development of fibrosis, cirrhosis, liver failure, and even hepatocellular carcinoma (3). In view of the adverse health consequences caused by hyperlipidemia, the search for lipidlowering drugs has been an area of intensive research.…”

Prevalence, patterns and predictive factors of non-alcoholic fatty liver disease among morbidly obese patients undergoing sleeve gastrectomy

“…45 The prevalence of dyslipidaemia, as a component of metabolic syndrome, among NAFLD patients varies from 20 per cent to 80 per cent. 46 In our study, more than half of NAFLD patients (55.5 per cent) and about two thirds of NASH patients (63 per cent) had deranged serum lipids, primarily elevated total cholesterol and TGs.…”