Nonalcoholic fatty liver disease and non-liver comorbidities

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease characterized by excess fat accumulation in the liver. It is closely associated with metabolic syndrome, and patients with NAFLD often have comorbidities such as obesity, type 2 diabetes mellitus, and dyslipidemia. In addition to liver-related complications, NAFLD has been associated with a range of non-liver comorbidities, including cardiovascular disease, chronic kidney disease, and sleep apnea. Cardiovascular disease is the most common cause of mortality in patients with NAFLD, and patients with NAFLD have a higher risk of developing cardiovascular disease than the general population. Chronic kidney disease is also more common in patients with NAFLD, and the severity of NAFLD is associated with a higher risk of developing chronic kidney disease. Sleep apnea, a disorder characterized by breathing interruptions during sleep, is also more common in patients with NAFLD and is associated with the severity of NAFLD. The presence of non-liver comorbidities in patients with NAFLD has important implications for the management of this disease. Treatment of comorbidities such as obesity, type 2 diabetes mellitus, and dyslipidemia may improve liver-related outcomes in patients with NAFLD. Moreover, treatment of non-liver comorbidities may also improve overall health outcomes in patients with NAFLD. Therefore, clinicians should be aware of the potential for non-liver comorbidities in patients with NAFLD and should consider the management of these comorbidities as part of the overall management of this disease.

New Insights into the Pathogenesis of Metabolic-Associated Fatty Liver Disease (MAFLD): Gut–Liver–Heart Crosstalk

“…MAFLD is also associated with congestive heart failure, which increases the risk of incident heart failure [ 109 ]. The presence of epicardial fat in MAFLD patients results in irregular energy metabolism in the left ventricle, which contributes to diastolic dysfunction [ 110 ].…”

“…Despite microbiota being a critical component involved in the pathophysiology of MAFLD, the most crucial factor determining the clinical outcome of MAFLD is cardiac manifestations, such as CVD. According to recent studies, MAFLD is an important risk factor for CVD, with a substantially increasing prevalence of CVD [ 25 , 109 ] ( Figure 3 ). Interestingly, dysregulation of the intestinal bacterial microbiota in patients with CVD and MAFLD could be a crucial contributing factor influencing the severity of metabolic dysfunction [ 124 ].…”

Implications of comorbidities in nonalcoholic fatty liver disease

“…In summary, the excellent review by Manikat and Nguyen is a timely reminder of the strong association between NAFLD and various comorbidities. (32) While causality of the association remains a matter of debate, clinicians should be aware of the important comorbid conditions and arrange assessment and treatment as appropriate. Accordingly, the current Asia-Pacific guidelines recommend routine assessment for adiposity, blood pressure, glucose and lipids in patients with NAFLD.…”

Comorbidities and Malignancy among NAFLD Patients Compared to the General Population, A Nation-Based Study

“…Obesity prevalence is estimated to be about 51% of NAFLD patients and about 82% of nonalcoholic steatohepatitis (NASH) patients, while the prevalence of diabetes, hypertension, and dyslipidemia are 22%, 40%, and 69% among NAFLD patients, with an even higher prevalence in NASH patients [ 1 ]. Other studies showed an increased risk of non-fatal cardiovascular events with an odds ratio of 2.52 in NAFLD patients compared to non-NAFLD patients, as well as an increased risk of congestive heart failure, atrial fibrillation, ischemic stroke, and chronic kidney disease [ 6 , 7 , 8 , 9 ]. However, there are only scant data published regarding the comparison of NAFLD patients and the general population.…”