Cardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease: An update

World J Gastroenterol. 2015 Jun 14;21(22):6820-34. doi: 10.3748/wjg.v21.i22.6820.

Abstract

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.

Keywords: Arterial stiffness; Cardiovascular disease; Chronic kidney disease; Inflammation; Liver fibrosis; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Statins.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / prevention & control
  • Cause of Death
  • Comorbidity
  • Diabetes Mellitus, Type 2 / epidemiology
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Life Style
  • Liver Cirrhosis / epidemiology
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / epidemiology*
  • Non-alcoholic Fatty Liver Disease / mortality
  • Non-alcoholic Fatty Liver Disease / therapy
  • Predictive Value of Tests
  • Prognosis
  • Renal Insufficiency, Chronic / epidemiology
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors