The Link between NAFLD and Metabolic Syndrome

Abstract

Metabolic syndrome (MetS) is characterized by an association of cardiovascular and diabetes mellitus type 2 risk factors. Although the definition of MetS slightly differs depending on the society that described it, its central diagnostic criteria include impaired fasting glucose, low HDL-cholesterol, elevated triglycerides levels and high blood pressure. Insulin resistance (IR) is believed to be the main cause of MetS and is connected to the level of visceral or intra-abdominal adipose tissue, which could be assessed either by calculating body mass index or by measuring waist circumference. Most recent studies revealed that IR may also be present in non-obese patients, and considered visceral adiposity to be the main effector of MetS’ pathology. Visceral adiposity is strongly linked with hepatic fatty infiltration also known as non-alcoholic fatty liver disease (NAFLD), therefore, the level of fatty acids in the hepatic parenchyma is indirectly linked with MetS, being both a cause and a consequence of this syndrome. Taking into consideration the present pandemic of obesity and its tendency to drift towards a progressively earlier onset due to the Western lifestyle, it leads to an increased NAFLD incidence. Novel therapeutic resources are lifestyle intervention with physical activity, Mediterranean diet, or therapeutic surgical respective metabolic and bariatric surgery or drugs such as SGLT-2i, GLP-1 Ra or vitamin E. NAFLD early diagnosis is important due to its easily available diagnostic tools such as non-invasive tools: clinical and laboratory variables (serum biomarkers): AST to platelet ratio index, fibrosis-4, NAFLD Fibrosis Score, BARD Score, fibro test, enhanced liver fibrosis; imaging-based biomarkers: Controlled attenuation parameter, magnetic resonance imaging proton-density fat fraction, transient elastography (TE) or vibration controlled TE, acoustic radiation force impulse imaging, shear wave elastography, magnetic resonance elastography; and the possibility to prevent its complications, respectively, fibrosis, hepato-cellular carcinoma or liver cirrhosis which can develop into end-stage liver disease.

Diagnostic Criteria and Prognostic Relevance of Sarcopenia in Patients with Inflammatory Bowel Disease—A Systematic Review

“…The patients with lower muscle mass have a higher risk of developing NAFLD (OR = 3.42, 95% CI 1.30-8.96, p = 0.002) [49]. The link between metabolic syndrome and NAFLD is well known, but patients with IBD are usually young and have a lower risk of metabolic syndrome due to malabsorption, malnutrition, and the disease itself [50][51][52]. Lower SMI is associated with a higher fatty liver index (FLI): 43.2 ± 3.9 at an FLI < 20, 40.2 ± 4.0 at an FLI between 20 and 59, and 38.2 ± 4.4 at an FLI ≥ 60.…”

This Is What Metabolic Dysfunction–Associated Steatotic Liver Disease Looks Like: Potential of a Multiparametric MRI Protocol

“…The rise of metabolic dysfunction associated steatotic liver disease (MASLD) globally demands urgent attention and innovative diagnostic approaches to combat its progression and devastating consequences 1 . This surge in MASLD, and its more severe form, metabolic dysfunction associated steatohepatitis (MASH), is closely linked to the escalating rates of obesity, type 2 diabetes, and metabolic syndrome, further complicated by genetic factors [2][3][4][5][6][7] . Moreover, the progressive fibrosis in advanced MASH can lead to cirrhosis and the development of other severe outcomes including hepatocellular carcinoma and portal hypertension 8,9 .…”

Efeitos hepáticos da cirurgia bariátrica em pacientes com doença hepática gordurosa não alcoólica: Qual a melhor técnica?

“…A doença hepática gordurosa não alcoólica (DHGNA), tornou-se a causa mais comum de doença hepática crônica nos países desenvolvidos. Estima-se que 30% da população global tenha DHGNA e a prevalência aumenta significativamente entre pacientes adultos com obesidade, resistência à insulina, diabetes mellitus tipo 2 (DM2) e dislipidemia (Pouwels et al, 2022;Radu et al, 2023;Yaqub et al, 2021). Acredita-se que esse fato esteja relacionado aos hábitos alimentares inadequados, sedentarismo e a predisposição genética (Laursen et al, 2019).…”