National Institute of Health Research Biomedical Research Unit, Southampton University Hospitals NHS Trust, Southampton General Hospital, Tremona Road, Southampton, UK.
Eur Heart J. 2012 May;33(10):1190-200. doi: 10.1093/eurheartj/ehr453. Epub 2012 Mar 8.
Non-alcoholic fatty liver disease (NAFLD) affects up to a third of the population worldwide and may confer increased cardiometabolic risk with consequent adverse cardiovascular outcomes independent of traditional cardiovascular risk factors and the metabolic syndrome. It is characterized almost universally by insulin resistance and is strongly associated with type 2 diabetes and obesity. Non-alcoholic fatty liver disease is a marker of pathological ectopic fat accumulation combined with a low-grade chronic inflammatory state. This results in several deleterious pathophysiological processes including abnormal glucose, fatty acid and lipoprotein metabolism, increased oxidative stress, deranged adipokine profile, hypercoaguability, endothelial dysfunction, and accelerated progression of atherosclerosis. This ultimately leads to a dysfunctional cardiometabolic phenotype with cardiovascular mortality representing the main mode of premature death in NAFLD. This review is aimed at introducing NAFLD to the clinical cardiologist by discussing in-depth the evidence to date linking NAFLD with cardiovascular disease, reviewing the likely mechanisms underlying this association, as well as summarizing from a cardiologist's perspective, current and potential future treatment options for this increasingly prevalent disease.
非酒精性脂肪性肝病（NAFLD）影响全球多达三分之一的人口，可能会增加心血管代谢风险，导致不良心血管结局，而与传统心血管危险因素和代谢综合征无关。它几乎普遍存在胰岛素抵抗，与 2 型糖尿病和肥胖密切相关。非酒精性脂肪性肝病是病理性异位脂肪堆积与低度慢性炎症状态的标志物。这导致了几种有害的病理生理过程，包括异常的葡萄糖、脂肪酸和脂蛋白代谢、氧化应激增加、脂联素谱紊乱、高凝状态、内皮功能障碍和动脉粥样硬化加速进展。这最终导致代谢功能障碍的心血管表型，心血管死亡率是 NAFLD 患者过早死亡的主要模式。通过深入讨论目前将 NAFLD 与心血管疾病联系起来的证据，回顾这种关联的潜在机制，并从心脏病专家的角度总结当前和潜在的未来治疗方案，本综述旨在向临床心脏病专家介绍 NAFLD。
