Nonalcoholic Fatty Liver Disease A Unique Entity or Part of the Metabolic Syndrome or Both
Document Type
Article
Publication Date
5-1-2023
Abstract
NAFLD is not a standalone liver disease but an integral part of the metabolic syn-drome; two conditions are bidirectionally related. With an increasing prevalence worldwide, NAFLD is a major contributor to mortality, not only from liver-related com-plications but more often from cardiovascular events and extrahepatic malignancies, which are strongly associated with metabolic syndrome. NAFLD generally increases the risk of various metabolic risk factors, specifically T2DM and insulin resistance, overweight and obesity, hypertension, and dyslipidemia. The presence of these meta-bolic risk factors in return intensifies the risks of NAFLD. Poorly-controlled metabolic risk factors are linked to more severe NAFLD like NASH, advanced fibrosis, and cirrhosis, and hence worse clinical outcomes. All such interlinked relationships make NAFLD not simply a liver disease but a hepatic manifestation of systemic meta-bolic dysfunction. Targeted screening for NAFLD in patients with T2DM, obesity, and metabolic syndrome is recommended by international guidelines, whereas the long-term benefits and cost-effectiveness of screening are to be established. Multidisci-plinary care pathways including lifestyle modifications, adequate control of metabolic factors, and hopefully the coming-soon pharmacologic treatments for NAFLD are crucial to improve the clinical outcomes of patients with NAFLD.
Keywords
Dyslipidemia, Hypertension, Obesity, Type 2 diabetes, Malignancies
Divisions
fac_med,medicinedept
Publication Title
Medical Clinics of North America
Volume
107
Issue
3
Publisher
Elsevier
Publisher Location
1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA