Open AccessCardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease: An update
Author(s) -
Vasilios G. Athyros,
Κωνσταντίνος Τζιόμαλος,
Niki Katsiki,
Michael Doumas,
Asterios Karagiannis,
Dimitri P. Mikhailidis
Publication year - 2015
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v21.i22.6820
Subject(s) - fatty liver , steatohepatitis , medicine , gastroenterology , risk factor , diabetes mellitus , fibrosis , steatosis , disease , type 2 diabetes , type 2 diabetes mellitus , chronic liver disease , metabolic syndrome , cirrhosis , endocrinology , obesity
Non-alcoholic fatty liver disease (NAFLD) is considered to be an independent cardiovascular disease (CVD) risk factor. However, simple steatosis has a benign clinical course without excess mortality. In contrast, the advanced form of NAFLD, non-alcoholic steatohepatitis (NASH) with liver fibrosis increases mortality by approximately 70%, due to an increase in CVD mortality by approximately 300%. Chronic kidney disease (CKD) may be caused by NAFLD/NASH and it substantially increases CVD risk, especially in the presence of type 2 diabetes mellitus. Moreover, CKD may trigger NAFLD/NASH deterioration in a vicious cycle. NAFLD/NASH is also related to increased arterial stiffness (AS), an independent CVD risk factor that further raises CVD risk. Diagnosis of advanced liver fibrosis (mainly by simple non-invasive tests), CKD, and increased AS should be made early in the course of NAFLD and treated appropriately. Lifestyle measures and statin treatment may help resolve NAFLD/NASH and beneficially affect the CVD risk factors mentioned above.