Laboratory of Experimental Medicine and Paediatrics (LEMP) - Gastroenterology & Hepatology, University of Antwerp, Wilrijk (Antwerp), Belgium; Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem (Antwerp), Belgium.
Laboratory of Experimental Medicine and Paediatrics (LEMP) - Gastroenterology & Hepatology, University of Antwerp, Wilrijk (Antwerp), Belgium.
J Hepatol. 2016 Aug;65(2):425-43. doi: 10.1016/j.jhep.2016.04.005. Epub 2016 Jun 1.
Non-alcoholic fatty liver disease (NAFLD) has become one of the most frequent chronic liver diseases in the Western society and its prevalence is likely to rise even further. An increasing body of evidence shows that NAFLD is not only a potentially progressive liver disease, but also has systemic consequences. More specifically, evidence points out that NAFLD has to be considered as a significant independent risk factor for subclinical and clinical cardiovascular disease (CVD). Long-term follow-up studies demonstrate cardiovascular mortality to be the most important cause of death in NAFLD patients. Moreover, ample evidence associates NAFLD with endothelial dysfunction, increased pulse wave velocity, increased coronary arterial calcifications and increased carotid intima media thickness, all established markers for CVD. Despite of all this evidence, the mechanisms by which NAFLD causally contributes to CVD are not fully elucidated. Furthermore, an extensive overview of all potential pathophysiological mechanisms and the corresponding current data are lacking. In this review we summarise current knowledge, originating from fundamental and clinical research, that mechanistically links NAFLD to CVD. Subsequently, the impact of CVD on current clinical practice and future research in the area of NALFD are discussed.
非酒精性脂肪性肝病（NAFLD）已成为西方社会最常见的慢性肝病之一，其患病率可能进一步上升。越来越多的证据表明，NAFLD 不仅是一种潜在的进行性肝病，而且还具有全身性后果。更具体地说，有证据表明，NAFLD 必须被视为亚临床和临床心血管疾病（CVD）的重要独立危险因素。长期随访研究表明，心血管疾病死亡率是 NAFLD 患者死亡的最重要原因。此外，大量证据将 NAFLD 与内皮功能障碍、脉搏波速度增加、冠状动脉钙化增加和颈动脉内膜中层厚度增加相关联，这些都是 CVD 的既定标志物。尽管有这些证据，但 NAFLD 导致 CVD 的机制尚未完全阐明。此外，缺乏对所有潜在病理生理机制的广泛概述和相应的最新数据。在这篇综述中，我们总结了源自基础和临床研究的现有知识，这些知识从机制上将 NAFLD 与 CVD 联系起来。随后，讨论了 CVD 对当前临床实践和 NALFD 领域未来研究的影响。
