Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang City, PR China.
Department of Cardiology, Dalian Friendship Hospital, Dalian City, PR China; and.
J Cardiovasc Pharmacol. 2023 May 1;81(5):327-335. doi: 10.1097/FJC.0000000000001418.
Nonalcoholic fatty liver disease (NAFLD) is an underappreciated independent risk factor for atherosclerotic cardiovascular diseases (ASCVDs). In recent years, the risk of ASCVD has increased along with the prevalence of NAFLD. ASCVD events are highly prevalent and are the main contributor to death in patients with NAFLD. The association between NAFLD and ASCVD has been validated in numerous observational, cohort, and genetic studies. Most of these studies agree that NAFLD significantly increases the risk of developing atherosclerosis and ASCVD. In addition, the underlying proatherosclerotic mechanisms of NAFLD have been gradually revealed; both disorders share several common pathophysiologic mechanisms including insulin resistance, whereas systemic inflammation and dyslipidemia driven by NAFLD directly promote atherosclerosis. Recently, NAFLD, as an emerging risk enhancer for ASCVD, has attracted attention as a potential treatment target for ASCVD. This brief review aims to illustrate the potential mechanistic insights, present recent clinically relevant investigations, and further explore the emerging therapies such as novel antidiabetic and lipid-lowering agents that could improve NAFLD and reduce ASCVD risk.
非酒精性脂肪性肝病(NAFLD)是动脉粥样硬化性心血管疾病(ASCVD)被低估的独立危险因素。近年来,随着 NAFLD 的流行,ASCVD 的风险增加。ASCVD 事件的发生率很高,是导致 NAFLD 患者死亡的主要原因。大量观察性、队列研究和遗传研究证实了 NAFLD 与 ASCVD 之间的关联。这些研究大多认为 NAFLD 显著增加了动脉粥样硬化和 ASCVD 的发病风险。此外,NAFLD 的潜在动脉粥样硬化发生机制逐渐被揭示;这两种疾病都有几个共同的病理生理机制,包括胰岛素抵抗,而由 NAFLD 驱动的全身炎症和血脂异常直接促进动脉粥样硬化。最近,NAFLD 作为 ASCVD 的新兴风险增强因子,作为 ASCVD 的潜在治疗靶点引起了关注。这篇简要综述旨在阐明潜在的机制见解,介绍最近与临床相关的研究,并进一步探讨新兴的治疗方法,如新型降糖和降脂药物,这些方法可能改善 NAFLD 并降低 ASCVD 风险。