Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
Ca' Granda IRCCS Foundation, Policlinico Hospital of Milan, 20122 Milan, Italy.
Int J Mol Sci. 2020 Nov 19;21(22):8761. doi: 10.3390/ijms21228761.
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Western countries and expose patients to increased risk of hepatic and cardiovascular (CV) morbidity and mortality. Both environmental factors and genetic predisposition contribute to the risk. An inappropriate diet, rich in refined carbohydrates, especially fructose, and saturated fats, and poor in fibers, polyunsaturated fats, and vitamins is one of the main key factors, as well as the polymorphism of patatin-like phospholipase domain containing 3 (PNPLA3 gene) for NAFLD and the apolipoproteins and the peroxisome proliferator-activated receptor (PPAR) family for the cardiovascular damage. Beyond genetic influence, also epigenetics modifications are responsible for various clinical manifestations of both hepatic and CV disease. Interestingly, data are accumulating on the interplay between diet and genetic and epigenetic modifications, modulating pathogenetic pathways in NAFLD and CV disease. We report the main evidence from literature on the influence of both macro and micronutrients in NAFLD and CV damage and the role of genetics either alone or combined with diet in increasing the risk of developing both diseases. Understanding the interaction between metabolic alterations, genetics and diet are essential to treat the diseases and tailoring nutritional therapy to control NAFLD and CV risk.
非酒精性脂肪性肝病（NAFLD）是西方国家最常见的慢性肝病，使患者面临增加的肝和心血管（CV）发病率和死亡率风险。环境因素和遗传易感性都促成了这种风险。饮食不当，富含精制碳水化合物，尤其是果糖和饱和脂肪，而纤维、多不饱和脂肪和维生素含量低，是主要的关键因素之一，此外，载脂蛋白和过氧化物酶体增殖物激活受体（PPAR）家族的多态性与 NAFLD 以及心血管损害有关。除了遗传影响外，表观遗传修饰也与肝脏和心血管疾病的各种临床表现有关。有趣的是，关于饮食与遗传和表观遗传修饰相互作用，调节 NAFLD 和 CV 疾病发病机制途径的资料正在不断积累。我们报告了文献中关于宏量营养素和微量营养素对 NAFLD 和 CV 损害的影响的主要证据，以及遗传因素单独或与饮食联合增加这两种疾病发病风险的作用。了解代谢改变、遗传学和饮食之间的相互作用对于治疗这些疾病以及定制营养治疗以控制 NAFLD 和 CV 风险至关重要。
