Orlić L, Mikolasevic I, Bagic Z, Racki S, Stimac D, Milic S
Division of Internal Medicine, Department of Nephrology and Dialysis, University Hospital Center Rijeka, 51000 Rijeka, Croatia.
Division of Internal Medicine, Department of Gastroenterology, University Hospital Center Rijeka, 51000 Rijeka, Croatia.
Gastroenterol Res Pract. 2014;2014:847539. doi: 10.1155/2014/847539. Epub 2014 Mar 6.
Research in recent years has led to the recognition of the importance of nonalcoholic fatty liver disease (NAFLD) and its relationship to the metabolic syndrome (MS). This has led to a growing interest in the potential prognostic value of NAFLD for adverse cardiovascular disease (CVD) outcome. On the other hand, searching for new risk factors for chronic kidney disease (CKD) development and progression is very important. Growing evidence suggests that the MS is an important factor in the pathogenesis of CKD. The best confirmation of this pathogenic link is hypertensive and diabetic nephropathy as the main causes of CKD. Furthermore, the possible link between NAFLD and CKD has also attracted research interest and recent data suggest an association between these two conditions. These findings have fuelled concerns that NAFLD may be a new and added risk factor for the development and progression of CKD. NAFLD and CKD share some important cardiometabolic risk factors and possible common pathophysiological mechanisms, and both are linked to an increased risk of incident CVD events. Therefore, common factors underlying the pathogenesis of NAFLD and CKD may be insulin resistance, oxidative stress, activation of rennin-angiotensin system, and inappropriate secretion of inflammatory cytokines by steatotic and inflamed liver.
近年来的研究已使人们认识到非酒精性脂肪性肝病（NAFLD）的重要性及其与代谢综合征（MS）的关系。这引发了人们对NAFLD对不良心血管疾病（CVD）结局潜在预后价值的日益关注。另一方面，寻找慢性肾脏病（CKD）发生和进展的新危险因素非常重要。越来越多的证据表明，MS是CKD发病机制中的一个重要因素。这种致病联系的最佳例证是高血压性和糖尿病性肾病作为CKD的主要病因。此外，NAFLD与CKD之间可能的联系也引起了研究兴趣，最近的数据表明这两种情况之间存在关联。这些发现引发了人们对NAFLD可能是CKD发生和进展的一个新的额外危险因素的担忧。NAFLD和CKD有一些重要的心脏代谢危险因素以及可能的共同病理生理机制，并且两者都与发生CVD事件的风险增加有关。因此，NAFLD和CKD发病机制的共同因素可能是胰岛素抵抗、氧化应激、肾素 - 血管紧张素系统的激活以及脂肪变性和炎症性肝脏不适当分泌炎性细胞因子。
