Garbuzenko Dmitry Victorovich
Department of Faculty Surgery, South Ural State Medical University, Chelyabinsk, Russia.
Gastroenterol Hepatol Bed Bench. 2022 Summer;15(3):194-203. doi: 10.22037/ghfbb.v15i3.2549.
Non-alcoholic fatty liver disease is one of the main liver diseases worldwide. The most common cause of death in patients with non-alcoholic fatty liver disease is cardiovascular disease. The relationship between these two conditions has been well established. Indeed, identical reasons may contribute to the development of cardiovascular disease and non-alcoholic fatty liver disease with lifestyle factors such as smoking, sedentariness, poor nutritional habits, and physical inactivity being major aspects. This review focuses on potential pathophysiological mechanisms of cardiovascular disorders in non-alcoholic fatty liver. PubMed, EMBASE, Orphanet, MIDLINE, Google Scholar, and Cochrane Library were searched for articles published between 2006 and 2022. Relevant articles were selected using the following terms: "Non-alcoholic fatty liver disease," "Сardiovascular diseases," "Pathophysiological mechanisms." The reference lists of all identified articles were searched for other relevant publications as well. The pathophysiological mechanisms of cardiovascular disorders in non-alcoholic fatty liver remain largely speculative and may include systemic low-grade inflammation, atherogenic dyslipidemia, abnormal glucose metabolism and hepatic insulin resistance, endothelial dysfunction, gut dysbiosis, as well as the associated cardiac remodeling, which are influenced by interindividual genetic and epigenetic variations. It is clear that the identification of pathophysiological mechanisms underlying cardiovascular disorders in non-alcoholic fatty liver disease will make the selection of therapeutic measures more optimal and effective.
非酒精性脂肪性肝病是全球主要的肝脏疾病之一。非酒精性脂肪性肝病患者最常见的死因是心血管疾病。这两种疾病之间的关系已得到充分证实。事实上,相同的原因可能导致心血管疾病和非酒精性脂肪性肝病的发生,吸烟、久坐不动、不良饮食习惯和缺乏体育锻炼等生活方式因素是主要方面。本综述重点关注非酒精性脂肪性肝病中心血管疾病潜在的病理生理机制。通过检索PubMed、EMBASE、Orphanet、MIDLINE、谷歌学术和Cochrane图书馆,查找2006年至2022年期间发表的文章。使用以下术语选择相关文章:“非酒精性脂肪性肝病”、“心血管疾病”、“病理生理机制”。还对所有已识别文章的参考文献列表进行检索,以查找其他相关出版物。非酒精性脂肪性肝病中心血管疾病的病理生理机制在很大程度上仍属推测,可能包括全身低度炎症、致动脉粥样硬化血脂异常、异常葡萄糖代谢和肝脏胰岛素抵抗、内皮功能障碍、肠道菌群失调以及相关的心脏重塑,这些都受到个体间遗传和表观遗传变异的影响。显然,确定非酒精性脂肪性肝病中心血管疾病的病理生理机制将使治疗措施的选择更加优化和有效。
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