Non-alcoholic fatty liver disease in women – Current knowledge and emerging concepts

Salem, Victoria; Forlano, Roberta; Tan, Tricia; Manousou, Pinelopi; Dhillo, Waljit S.; Izzi‐Engbeaya, Chioma

doi:10.1016/j.jhepr.2023.100835

Cited by 21 publications

(11 citation statements)

References 141 publications

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“…98,99 In contrast, postmenopausal women with MASLD loose this protection and are at higher risk for advanced fibrosis than men, reflecting the hepatoand cardioprotective properties of oestrogen to among others suppress lipogenesis, increase fatty acid oxidation and ameliorate insulin sensitivity. [99][100][101] The sexual dimorphism in cardiometabolic disease is at least partly attributable to the different adipose tissue distribution between women and men, since an elevated BMI in premenopausal women can be based on relatively benign subcutaneous adipose tissue, compared with android visceral adipose tissue in men. 102 Consequently, women suffering from the polycystic ovarium syndrome, a reproductive disorder associated with excess androgens, also have a higher prevalence of the metabolic syndrome and MASLD with more severe MASH and advanced fibrosis, [103][104][105] as well as CVD on the long-term.…”

Section: Discussionmentioning

confidence: 99%

“…Women of reproductive age are protected from MASLD with a risk reduction of approximately 50% compared with men, while also being protected from fibrosis development in the occasion that MASLD develops 98,99 . In contrast, postmenopausal women with MASLD loose this protection and are at higher risk for advanced fibrosis than men, reflecting the hepato‐ and cardioprotective properties of oestrogen to among others suppress lipogenesis, increase fatty acid oxidation and ameliorate insulin sensitivity 99–101 . The sexual dimorphism in cardiometabolic disease is at least partly attributable to the different adipose tissue distribution between women and men, since an elevated BMI in premenopausal women can be based on relatively benign subcutaneous adipose tissue, compared with android visceral adipose tissue in men 102 .…”

Section: Discussionmentioning

confidence: 99%

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Liver stiffness as a cornerstone in heart disease risk assessment

Boeckmans,

Sandrin,

Knackstedt

et al. 2023

Liver International

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Metabolic dysfunction‐associated steatotic liver disease (MASLD) typically presents with hepatic fibrosis in advanced disease, resulting in increased liver stiffness. A subset of patients further develops liver cirrhosis and hepatocellular carcinoma. Cardiovascular disease is a common comorbidity in patients with MASLD and its prevalence is increasing in parallel. Recent evidence suggests that especially liver stiffness, whether or not existing against a background of MASLD, is associated with heart diseases. We conducted a narrative review on the role of liver stiffness in the prediction of highly prevalent heart diseases including heart failure, cardiac arrhythmias (in particular atrial fibrillation), coronary heart disease, and aortic valve sclerosis. Research papers were retrieved from major scientific databases (PubMed, Web of Science) until September 2023 using ‘liver stiffness’ and ‘liver fibrosis’ as keywords along with the latter cardiac conditions. Increased liver stiffness, determined by vibration‐controlled transient elastography or hepatic fibrosis as predicted by biomarker panels, are associated with a variety of cardiovascular diseases, including heart failure, atrial fibrillation, and coronary heart disease. Elevated liver stiffness in patients with metabolic liver disease should lead to considerations of cardiac workup including N‐terminal pro–B‐type natriuretic peptide/B‐type natriuretic peptide determination, electrocardiography, and coronary computed tomography angiography. In addition, patients with MASLD would benefit from heart disease case‐finding strategies in which liver stiffness measurements can play a key role. In conclusion, increased liver stiffness should be a trigger to consider a cardiac workup in metabolically compromised patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Liver stiffness as a cornerstone in heart disease risk assessment

Boeckmans,

Sandrin,

Knackstedt

et al. 2023

Liver International

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“…BPA induces increased peroxisome proliferators–activated receptor γ (PPARγ) expression, causing downregulation of metabolic enzymes of cytochromes P450 (CYP) family and increasing the lipid accumulation in the cells 37 . Currently, oestrogen deficiency is recognized as a risk factor for hepatic steatosis 38 . BPA was shown to bind G protein‐coupled oestrogen receptor (GPER) and associated with fat accumulation in the liver of experimental animals 39 .…”

Section: Bisphenols Endocrine Disruption and Carcinogenicitymentioning

confidence: 99%

“…37 Currently, oestrogen deficiency is recognized as a risk factor for hepatic steatosis. 38 BPA was shown to bind G protein-coupled oestrogen receptor (GPER) and associated with fat accumulation in the liver of experimental animals. 39 Therefore, it appears that BPA reduces the binding of oestrogen with GPERs and thus diminishes its protective action on hepatic steatosis (Figure 2).…”

Section: B Is Phenol S Endocrine Dis Rup Tion and C Arcinog Enicit Ymentioning

confidence: 99%

Plastic compounds and liver diseases: Whether bisphenol A is the only culprit

Sangwan,

Bhattacharyya,

Banerjee

2024

Liver International

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Plastics, while providing modern conveniences, have become an inescapable source of global concern due to their role in environmental pollution. Particularly, the focus on bisphenol A (BPA) reveals its biohazardous nature and association with liver issues, specifically steatosis. However, research indicates that BPA is just one facet of the problem, as other bisphenol analogues, microplastics, nanoplastics and additional plastic derivatives also pose potential risks. Notably, BPA is implicated in every stage of non‐alcoholic fatty liver disease (NAFLD) onset and progression, surpassing hepatitis B virus as a primary cause of chronic liver disease worldwide. As plastic contamination tops the environmental contaminants list, urgent action is needed to assess causative factors and mitigate their impact. This review delves into the molecular disruptions linking plastic pollutant exposure to liver diseases, emphasizing the broader connection between plastics and the rising prevalence of NAFLD.

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“…NAFLD and, subsequently, steatohepatitis, a noncommunicable disease with no approved pharmacotherapy, is the most prevalent chronic liver disease and the leading etiology for liver transplant in women . NAFLD is linked to excessive calorie intake and a sedentary lifestyle; however, it remains important to identify behavioral risk factors for development of NAFLD. This study could provide more insight into the association between sugar intake and NAFLD status.…”

mentioning

confidence: 99%

Sugar-Sweetened Beverages and Risk of Liver Disease

Ayada,

Li,

Pan

2023

JAMA

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Non-alcoholic fatty liver disease in women – Current knowledge and emerging concepts

Cited by 21 publications

References 141 publications

Liver stiffness as a cornerstone in heart disease risk assessment

Liver stiffness as a cornerstone in heart disease risk assessment

Plastic compounds and liver diseases: Whether bisphenol A is the only culprit

Sugar-Sweetened Beverages and Risk of Liver Disease

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