Non-alcoholic fatty liver disease and cardiovascular disease: assessing the evidence for causality

AbstractNon-alcoholic fatty liver disease (NAFLD) is highly prevalent among individuals with type 2 diabetes. Although epidemiological studies have shown that NAFLD is associated with cardiovascular disease (CVD), it remains unknown whether NAFLD is an active contributor or an innocent bystander. Plasma lipids, low-grade inflammation, impaired fibrinolysis and hepatokines are potential mediators of the relationship between NAFLD and CVD. The Mendelian randomisation approach can help to make causal inferences. Studies that used common variants inPNPLA3,TM6SF2 andGCKR as instruments to investigate the relationship between NAFLD and coronary artery disease (CAD) have reported contrasting results. Variants inPNPLA3 andTM6SF2 were found to protect against CAD, whereas variants inGCKR were positively associated with CAD. Since all three genes have been associated with non-alcoholic steatohepatitis, the second stage of NAFLD, the question of whether low-grade inflammation is an important mediator of the relationship between NAFLD and CAD arises. In contrast, the differential effects of these genes on plasma lipids (i.e. lipid-lowering forPNPLA3 andTM6SF2, and lipid-raising forGCKR) strongly suggest that plasma lipids account for their differential effects on CAD risk. This concept has recently been confirmed in an extended set of 12 NAFLD susceptibility genes. From these studies it appears that plasma lipids are an important mediator between NAFLD and CVD risk. These findings have i...
Source: Diabetologia - Category: Endocrinology Source Type: research

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Authors: Le P, Chaitoff A, Rothberg MB, McCullough A, Alkhouri N Abstract BackgroundWe aimed to estimate population-based trends in prevalence of coexisting type 2 diabetes (T2D) and suspected non-alcoholic fatty liver disease (NAFLD) and pioglitazone use among US adults.Research design and methodsWe conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey from 2003-2016. We included people aged ≥18 years who had HbA1C>6.4%, fasting plasma glucose>125 mg/dL, or were told they had diabetes by a doctor. Suspected NAFLD was defined using hepatic steatosis index of>36. Pr...
Source: Expert Opinion on Investigational Drugs - Category: Drugs & Pharmacology Tags: Expert Opin Investig Drugs Source Type: research
ConclusionsChildren with obesity and increased liver transaminases as surrogates of NAFLD should be screened for T2DM.
Source: Pediatric Obesity - Category: Eating Disorders & Weight Management Authors: Tags: ORIGINAL RESEARCH Source Type: research
DiscussionThis overview will assess current evidence from systematic reviews for the association between cadmium exposure and risk of T2DM and other metabolic morbidities. This overview may be helpful for policy-makers and healthcare teams aiming to mitigate T2DM risk in populations at risk of cadmium exposure.Systematic review registrationPROSPERO CRD42019125956
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
CONCLUSIONS: Liraglutide could upregulate autophagy to decrease lipid over-accumulation via the AMPK/mTOR pathway. PMID: 31787541 [PubMed - as supplied by publisher]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Abstract BACKGROUND: Leukocyte telomere has been shown to be related to insulin resistance-related diseases, such as type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). This cross-sectional study investigated the association of leukocyte telomere length (LTL) with NAFLD in T2DM patients. METHODS: Clinical features were collected and LTL was measured by Southern blot-based terminal restriction fragment length analysis in 120 T2DM patients without NAFLD and 120 age-matched T2DM patients with NAFLD. NAFLD was clinically defined by manifestations of ultrasonography. The correlation betw...
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
Non-alcoholic fatty liver disease (NAFLD) is characterized by triglyceride accumulation in the hepatocytes in the absence of alcohol overconsumption, commonly associated with insulin resistance and obesity. Bo...
Source: Journal of Translational Medicine - Category: Research Authors: Tags: Protocol Source Type: research
Laparra JM Abstract Non-alcoholic fatty liver disease (NAFLD) is indisputably the most widespread liver disease worldwide, leading to a significant increase in patient morbidity, mortality, and health care utilization. The gut microbiota and its genome (microbiome) have emerged as a novel modulator of the immunometabolic processes that NAFLD implies, but microbiota-targeted interventions have resulted both astounding and at the same time unsuccessful. The most relevant alteration appears to be the overgrowth of Gram-negative bacteria, characterized by an increased ratio of Firmicutes to Bacteroidetes, although cu...
Source: Nutricion Hospitalaria - Category: Nutrition Authors: Tags: Nutr Hosp Source Type: research
This study explored the proportion of NAFLD cases and increased liver fibrosis (LF), and the association between LF and either chronic kidney disease (CKD) or cardiovascular complications in T2DM patients. METHODS: - The study included 137 patients with non-insulin-treated T2DM and no known liver disease consecutively attending our diabetes outpatients service who underwent liver ultrasonography and liver stiffness measurement (LSM) using vibration-controlled transient elastography (FibroScan®). RESULTS: - The proportion of patients with hepatic steatosis on ultrasonography was 73.7%, and the proportion with ...
Source: Diabetes and Metabolism - Category: Endocrinology Authors: Tags: Diabetes Metab Source Type: research
AbstractNon ‐alcoholic fatty liver disease (NAFLD) is one of the most common liver disorders worldwide. NAFLD is considered to be the hepatic component of metabolic syndrome because its features are very similar to those of metabolic disorders such as obesity, inflammation, insulin resistance, and type 2 diab etes. It is clear that NAFLD and type 2 diabetes have a close relationship. However, the exact mechanisms underlying the pathogenesis and progression of NAFLD are still incompletely understood1 ‐3).
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: Commentary Source Type: research
CONCLUSION: A significant percentage of the American general population is afflicted by BAFLD and these patients tend to have more advanced liver fibrosis. PMID: 31749901 [PubMed]
Source: World Journal of Hepatology - Category: Gastroenterology Tags: World J Hepatol Source Type: research
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