Department of Internal Medicine, Endocrinology, Metabolism and Geriatrics, Nuovo Ospedale Civile Sant'Agostino-Estense di Modena, University of Modena and Reggio Emilia, Modena, Italy.
Arch Med Res. 2011 Jul;42(5):337-53. doi: 10.1016/j.arcmed.2011.08.004. Epub 2011 Aug 16.
Nonalcoholic fatty liver disease (NAFLD), which spans a spectrum of conditions ranging from simple steatosis to progressive nonalcoholic steatohepatitis (NASH), is the most common chronic liver disease and a relevant public health issue. The prevalence of NAFLD depends on adiposity, age, gender and ethnicity. The natural history of liver disease in those with NAFLD critically depends on liver histological changes. However, cardiovascular mortality is increased in NAFLD, particularly in middle-aged adults. Against such a background, this review consists of three sections. First, data on NAFLD as a novel mechanism of increased cardiovascular risk via hyperinsulinism, pro-thrombotic potential, and subclinical inflammation are summarized. Next, the role of atherogenic liver in the development of manifestations of oxidative stress and atherosclerosis is emphasized. Finally, whether and how treating NAFLD will mechanistically result in reduced cardiovascular risk through ameliorated metabolic syndrome is discussed.
非酒精性脂肪性肝病（NAFLD），其涵盖了一系列从单纯性脂肪变性到进展性非酒精性脂肪性肝炎（NASH）的疾病谱，是最常见的慢性肝脏疾病，也是一个相关的公共卫生问题。NAFLD 的患病率取决于肥胖、年龄、性别和种族。患有 NAFLD 的患者的肝病自然史严重依赖于肝组织学变化。然而，NAFLD 患者的心血管死亡率增加，尤其是在中年成年人中。在这种背景下，本综述分为三个部分。首先，总结了通过高胰岛素血症、促血栓形成潜能和亚临床炎症，NAFLD 作为增加心血管风险的新机制的数据。其次，强调了动脉粥样硬化性肝脏在氧化应激和动脉粥样硬化表现发展中的作用。最后，讨论了是否以及如何通过改善代谢综合征，从机制上降低 NAFLD 治疗的心血管风险。
