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非酒精性脂肪性肝病大流行助推心血管疾病浪潮。

Nonalcoholic Fatty Liver Disease Pandemic Fuels the Upsurge in Cardiovascular Diseases.

机构信息

Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.C.).

Institute of Model Animal of Wuhan University, China (J.C., X.-J.Z., Y.-X.J., P.Z., Z.-G.S., H.L.).

出版信息

Circ Res. 2020 Feb 28;126(5):679-704. doi: 10.1161/CIRCRESAHA.119.316337. Epub 2020 Feb 27.

Abstract

Cardiovascular diseases (CVDs) remain a leading cause of death worldwide. Among the major risk factors for CVD, obesity and diabetes mellitus have received considerable attention in terms of public policy and awareness. However, the emerging prevalence of nonalcoholic fatty liver disease (NAFLD), as the most common liver and metabolic disease and a cause of CVD, has been largely overlooked. Currently, the number of individuals with NAFLD is greater than the total number of individuals with diabetes mellitus and obesity. Epidemiological studies have established a strong correlation between NAFLD and an increased risk of CVD and CVD-associated events. Although debate continues over the causal relationship between NAFLD and CVD, many mechanistic and longitudinal studies have indicated that NAFLD is one of the major driving forces for CVD and should be recognized as an independent risk factor for CVD apart from other metabolic disorders. In this review, we summarize the clinical evidence that supports NAFLD as a risk factor for CVD epidemics and discuss major mechanistic insights regarding the acceleration of CVD in the setting of NAFLD. Finally, we address the potential treatments for NAFLD and their potential impact on CVD.

摘要

心血管疾病(CVDs)仍然是全球范围内的主要死亡原因。在 CVD 的主要危险因素中,肥胖症和糖尿病受到了公共政策和意识的广泛关注。然而,非酒精性脂肪性肝病(NAFLD)作为最常见的肝脏和代谢性疾病,以及 CVD 的一个病因,其患病率的不断上升在很大程度上被忽视了。目前,NAFLD 患者的数量超过了糖尿病和肥胖症患者的总和。流行病学研究已经证实了 NAFLD 与 CVD 风险增加以及与 CVD 相关的事件之间存在很强的相关性。尽管关于 NAFLD 与 CVD 之间的因果关系仍存在争议,但许多机制和纵向研究表明,NAFLD 是 CVD 的主要驱动因素之一,除了其他代谢紊乱外,还应将其视为 CVD 的独立危险因素。在这篇综述中,我们总结了支持 NAFLD 作为 CVD 流行的危险因素的临床证据,并讨论了关于在 NAFLD 背景下加速 CVD 的主要机制见解。最后,我们探讨了 NAFLD 的潜在治疗方法及其对 CVD 的潜在影响。

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