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Extrahepatic complications of nonalcoholic fatty liver disease
Author(s) -
Armstrong Matthew J.,
Adams Leon A.,
Canbay Ali,
Syn WingKin
Publication year - 2014
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.26717
Subject(s) - medicine , nonalcoholic fatty liver disease , metabolic syndrome , kidney disease , disease , fatty liver , gastroenterology , chronic liver disease , population , diabetes mellitus , steatohepatitis , endocrinology , obesity , cirrhosis , environmental health
Nonalcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease, and is strongly associated with the metabolic syndrome. In the last decade, it has become apparent that the clinical burden of NAFLD is not restricted to liver‐related morbidity or mortality, and the majority of deaths in NAFLD patients are related to cardiovascular disease (CVD) and cancer. These findings have fuelled concerns that NAFLD may be a new, and added risk factor for extrahepatic diseases such as CVD, chronic kidney disease (CKD), colorectal cancer, endocrinopathies (including type 2 diabetes mellitus [T2DM] and thyroid dysfunction), and osteoporosis. In this review we critically appraise key studies on NAFLD‐associated extrahepatic disease. There was marked heterogeneity between studies in study design (cross‐sectional versus prospective; sample size; presence/absence of well‐defined controls), population (ethnic diversity; community‐based versus hospital‐based cohorts), and method of NAFLD diagnosis (liver enzymes versus imaging versus biopsy). Taking this into account, the cumulative evidence to date suggests that individuals with NAFLD (specifically, nonalcoholic steatohepatitis) harbor an increased and independent risk of developing CVD, T2DM, CKD, and colorectal neoplasms. We propose future studies are necessary to better understand these risks, and suggest an example of a screening strategy. (H epatology 2014;59:1174–1197)