NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications

Gut, Год журнала: 2020, Номер 69(9), С. 1691 - 1705

Опубликована: Апрель 22, 2020

Non-alcoholic fatty liver disease (NAFLD) is a public health problem, affecting up to third of the world's adult population. Several cohort studies have consistently documented that NAFLD (especially in its more advanced forms) associated with higher risk all-cause mortality and leading causes death among patients are cardiovascular diseases (CVDs), followed by extrahepatic malignancies liver-related complications. A growing body evidence also indicates strongly an increased major CVD events other cardiac complications (ie, cardiomyopathy, valvular calcification arrhythmias), independently traditional factors. This narrative review provides overview literature on: (1) for association between cardiovascular, arrhythmic complications, (2) putative pathophysiological mechanisms linking (3) current pharmacological treatments might benefit or adversely affect CVD.

Язык: Английский

---

Resmetirom (MGL-3196) for the treatment of non-alcoholic steatohepatitis: a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial

The Lancet, Год журнала: 2019, Номер 394(10213), С. 2012 - 2024

Опубликована: Ноя. 1, 2019

Язык: Английский

---

Mortality in biopsy-confirmed nonalcoholic fatty liver disease: results from a nationwide cohort

Gut, Год журнала: 2020, Номер 70(7), С. 1375 - 1382

Опубликована: Окт. 9, 2020

Objective Population-based data are lacking regarding the risk of overall and cause-specific mortality across complete histological spectrum non-alcoholic fatty liver disease (NAFLD). Design This nationwide, matched cohort study included all individuals in Sweden with biopsy-confirmed NAFLD (1966 to 2017; n=10 568). was confirmed histologically from biopsies submitted Sweden’s 28 pathology departments, after excluding other etiologies disease, further categorised as, simple steatosis, non-fibrotic steatohepatitis (NASH), non-cirrhotic fibrosis cirrhosis. cases were ≤5 general population comparators by age, sex, calendar year county (n=49 925). Using Cox regression, we estimated multivariable-adjusted HRs (aHRs) 95% CIs. Results Over a median 14.2 years, 4,338 patients died. Compared controls, had significantly increased (16.9 vs 28.6/1000 PY; difference=11.7/1000 aHR=1.93, CI=1.86 2.00). significant excess observed steatosis (8.3/1000 PY, aHR=1.71, CI=1.64 1.79), NASH (13.4/1000 aHR=2.14, CI=1.93 2.38), (18.4/1000 aHR=2.44, CI=2.22 2.69) cirrhosis (53.6/1000 aHR=3.79, CI=3.34 4.30)(p trend <0.01). dose-dependent gradient similar when reference (p The associated primarily extrahepatic cancer (4.5/1000 aHR=2.16, CI=2.03 2.30), followed (2.7/1000 aHR=18.15, CI=14.78 22.30), cardiovascular (1.4/1000 aHR=1.35, CI=1.26 1.44) hepatocellular carcinoma (HCC) (1.2/1000 aHR=11.12, CI=8.65 14.30). Conclusion All stages mortality, this progressively worsening histology. Most cirrhosis, while contrast, contributions HCC modest.

Язык: Английский

---

NAFLD and cardiovascular diseases: a clinical review

Clinical Research in Cardiology, Год журнала: 2020, Номер 110(7), С. 921 - 937

Опубликована: Июль 21, 2020

Abstract Non-alcoholic fatty liver DISEASE (NAFLD) is the most common chronic disease in Western countries and affects approximately 25% of adult population. Since NAFLD frequently associated with further metabolic comorbidities such as obesity, type 2 diabetes mellitus, or dyslipidemia, it generally considered hepatic manifestation syndrome. In addition to its potential cause liver-related morbidity mortality, also subclinical clinical cardiovascular (CVD). Growing evidence indicates that patients are at substantial risk for development hypertension, coronary heart disease, cardiomyopathy, cardiac arrhythmias, which clinically result increased mortality. The natural history variable vast majority will not progress from simple steatosis fibrosis end stage disease. However, progressive forms NAFLD, including non-alcoholic steatohepatitis (NASH) and/or advanced fibrosis, well concomitant types highest CVD. This review describes underlying pathophysiological mechanisms linking CVD, discusses role a dysfunction factor, focuses on manifestations patients.

Язык: Английский

---

Complications, morbidity and mortality of nonalcoholic fatty liver disease

Metabolism, Год журнала: 2020, Номер 111, С. 154170 - 154170

Опубликована: Янв. 30, 2020

Язык: Английский

---

Mechanisms of Cardiorenal Effects of Sodium-Glucose Cotransporter 2 Inhibitors

Journal of the American College of Cardiology, Год журнала: 2020, Номер 75(4), С. 422 - 434

Опубликована: Янв. 27, 2020

Язык: Английский

---

Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis

˜The œLancet. Gastroenterology & hepatology, Год журнала: 2021, Номер 6(11), С. 903 - 913

Опубликована: Сен. 21, 2021

Язык: Английский

---

Non-alcoholic fatty liver disease: a multisystem disease requiring a multidisciplinary and holistic approach

˜The œLancet. Gastroenterology & hepatology, Год журнала: 2021, Номер 6(7), С. 578 - 588

Опубликована: Май 4, 2021

Язык: Английский

---

Dietary Fructose and the Metabolic Syndrome

Nutrients, Год журнала: 2019, Номер 11(9), С. 1987 - 1987

Опубликована: Авг. 22, 2019

Abstract: Consumption of fructose, the sweetest all naturally occurring carbohydrates, has increased dramatically in last 40 years and is today commonly used commercially soft drinks, juice, baked goods. These products comprise a large proportion modern diet, particular children, adolescents, young adults. A body evidence associate consumption fructose other sugar-sweetened beverages with insulin resistance, intrahepatic lipid accumulation, hypertriglyceridemia. In long term, these risk factors may contribute to development type 2 diabetes cardiovascular diseases. Fructose absorbed small intestine metabolized liver where it stimulates fructolysis, glycolysis, lipogenesis, glucose production. This result hypertriglyceridemia fatty liver. Therefore, understanding mechanisms underlying intestinal hepatic metabolism important. Here we review recent linking excessive health markers components Metabolic Syndrome.

Язык: Английский

---

Association of Bariatric Surgery With Major Adverse Liver and Cardiovascular Outcomes in Patients With Biopsy-Proven Nonalcoholic Steatohepatitis

JAMA, Год журнала: 2021, Номер 326(20), С. 2031 - 2031

Опубликована: Ноя. 11, 2021

No therapy has been shown to reduce the risk of serious adverse outcomes in patients with nonalcoholic steatohepatitis (NASH).To investigate long-term relationship between bariatric surgery and incident major liver cardiovascular events (MACE) obesity biopsy-proven fibrotic NASH without cirrhosis.In SPLENDOR (Surgical Procedures Long-term Effectiveness Disease Obesity Risk) study, 25 828 biopsies performed at a US health system 2004 2016, 1158 adult were identified who fulfilled enrollment criteria, including confirmed histological diagnosis presence fibrosis (histological stages 1-3). Baseline clinical characteristics, disease activity, stage underwent simultaneous biopsy time balanced nonsurgical control group using overlap weighting methods. Follow-up ended March 2021.Bariatric (Roux-en-Y gastric bypass, sleeve gastrectomy) vs care.The primary incidence (progression or cirrhosis, development hepatocellular carcinoma, transplantation, liver-related mortality) MACE (a composite coronary artery events, cerebrovascular heart failure, death), estimated Firth penalized method multivariable-adjusted Cox regression analysis framework.A total (740 [63.9%] women; median age, 49.8 years [IQR, 40.9-57.9 years], body mass index, 44.1 39.4-51.4]), 650 508 group, follow-up 7 (IQR, 4-10 years) analyzed. Distribution baseline covariates, severity injury, was well-balanced after weighting. At end study period unweighted data set, 5 40 experienced outcomes, 39 60 MACE. Among analyzed methods, cumulative 10 2.3% (95% CI, 0%-4.6%) 9.6% 6.1%-12.9%) (adjusted absolute difference, 12.4% [95% 5.7%-19.7%]; adjusted hazard ratio, 0.12 0.02-0.63]; P = .01). The 8.5% 5.5%-11.4%) 15.7% 11.3%-19.8%) 13.9% 5.9%-21.9%]; 0.30 0.12-0.72]; .007). Within first year surgery, 4 (0.6%) died from surgical complications, gastrointestinal leak (n 2) respiratory failure 2).Among obesity, compared management, associated significantly lower

Язык: Английский

---