scholarly journals Hospital admission with non-alcoholic fatty liver disease is associated with increased all-cause mortality independent of cardiovascular risk factors

2019 ◽  
Author(s):  
Jake P. Mann ◽  
Paul Carter ◽  
Matthew J. Armstrong ◽  
Hesham K Abdelaziz ◽  
Hardeep Uppal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Hospitalised Patients ◽  
All Cause Mortality ◽  
Alcoholic Fatty Liver Disease

AbstractBackgroundNon-alcoholic fatty liver disease (NAFLD) is common and strongly associated with the metabolic syndrome. Though NAFLD may progress to end-stage liver disease, the top cause of mortality in NAFLD is cardiovascular disease (CVD). Most of the data on liver-related mortality in NAFLD derives from specialist liver centres. We aimed to assess mortality in NAFLD when adjusting for CVD in a ‘real world’ cohort of inpatients.MethodsRetrospective study of hospitalised patients with 14-years follow-up. NAFL (non-alcoholi c fatty liver), non-alcoholic steatohepatitis (NASH), and NAFLD-cirrhosis groups were defined by ICD-10 codes using ACALM methodology. Cases were age-/sex-matched 1:10 with non-NAFLD hospitalised patients from the ACALM registry. All-cause mortality was compared between groups using cox regression adjusted for CVD and metabolic syndrome risk factors.ResultsWe identified 1238 patients with NAFL, 105 with NASH and 1235 with NAFLD-cirrhosis. There was an increasing burden of cardiovascular disease with progression from NAFL to NASH to cirrhosis. After adjustment for demographics, metabolic syndrome components and cardiovascular disease, patients with NAFL, NASH, and cirrhosis all had increased all-cause mortality (HR 1.3 (CI 1.1-1.5), HR 1.5 (CI 1.0-2.3) and HR 3.5 (CI 3.3-3.9), respectively). Hepatic decompensation (NAFL HR 8.0 (CI 6.1-10.4), NASH HR 6.5 (2.7-15.4) and cirrhosis HR 85.8 (CI 72-104)), and hepatocellular carcinoma were increased in all NAFLD groups.ConclusionThere is a high burden of cardiovascular disease in NAFLD-cirrhosis patients. From a large “real-life” non-specialist registry of hospitalized patients, NAFLD patients have increased overall mortality and rate of liver-related complications compared to controls after adjusting for cardiovascular disease.

Comorbidity of non-alcoholic fatty liver disease and cardiovascular disease: focus on ademetionine and ursodeoxycholic acid

2021 ◽  
Vol 1 (29) ◽  
pp. 13-20
Author(s):  
O. A. Polyakova ◽  
O. D. Ostroumova ◽  
G. P. Kovaleva ◽  
E. E. Pavleeva
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Liver Disease ◽  
Fatty Liver ◽  
Ursodeoxycholic Acid ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Medical Needs ◽  
The Relationship ◽  
Alcoholic Fatty Liver Disease

Changes in the nature of the interaction of risk factors and global aging of the population have led to a rapid increase in patients with combined pathology, elevated to the rank of a new non-infectious epidemic. The previously existing ‘one disease, one patient’ paradigm is losing its relevance and no longer meets medical needs, therefore patients with comorbidities need a broader approach and individualized treatment regimens, which are currently not fully defined. According to modern concepts, the coexistence of pathogenetically and pathophysiologically interrelated two or more diseases in one individual is defined by the term ‘comorbidity’. The most common comorbidity phenotype is cardiometabolic. Of particular interest is the relationship between cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD), since both diseases are highly prevalent in the population and have common metabolic risk factors (obesity, diabetes mellitus, hypertension, and dyslipidemia). In addition, there is evidence that NAFLD is an independent risk factor for CVD, which suggests not only the presence of common pathogenetic mechanisms other than metabolic pathways, but also the likelihood that treatment of liver disease can reduce the burden of CVD. In this regard, this review comprehensively analyzes the relationship between NAFLD and CVD and discusses a possible therapeutic strategy, including the use of a combination of ademetionine with ursodeoxycholic acid.

scholarly journals Metabolic syndrome and risk factors for non-alcoholic fatty liver disease

2012 ◽  
Vol 49 (1) ◽  
pp. 89-96 ◽  
Author(s):  
Mônica Rodrigues de Araújo Souza ◽  
Margareth de Fátima Formiga de Melo Diniz ◽  
José Eymard Moraes de Medeiros-Filho ◽  
Maria Salete Trigueiro de Araújo
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Experimental Studies ◽  
Final Analysis ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Steatohepatitis ◽  
Alcoholic Fatty Liver Disease

CONTEXT: Non-alcoholic fatty liver disease (NAFLD), hepatic manifestation of metabolic syndrome, has been considered the most common liver disease nowadays, which is also the most frequent cause of elevated transaminases and cryptogenic cirrhosis. The greatest input of fatty acids into the liver and consequent increased beta-oxidation contribute to the formation of free radicals, release of inflammatory cytokines and varying degrees of hepatocytic aggression, whose histological expression may vary from steatosis (HS) to non-alcoholic steatohepatitis (NASH). The differentiation of these forms is required by the potential risk of progression to cirrhosis and development of hepatocellular carcinoma. OBJECTIVE: To review the literature about the major risk factors for NAFLD in the context of metabolic syndrome, focusing on underlying mechanisms and prevention. METHOD: PubMed, MEDLINE and SciELO data basis analysis was performed to identify studies describing the link between risk factors for metabolic syndrome and NAFLD. A combination of descriptors was used, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, metabolic syndrome and risk factors. At the end, 96 clinical and experimental studies, cohorts, meta-analysis and systematic reviews of great impact and scientific relevance to the topic, were selected. RESULTS: The final analysis of all these data, pointed out the central obesity, type 2 diabetes, dyslipidemia and hypertension as the best risk factors related to NAFLD. However, other factors were highlighted, such as gender differences, ethnicity, genetic factors and the role of innate immunity system. How these additional factors may be involved in the installation, progression and disease prognosis is discussed. CONCLUSION: Risk factors for NAFLD in the context of metabolic syndrome expands the prospects to 1) recognize patients with metabolic syndrome at high risk for NAFLD, 2) elucidate pathways common to other co-morbidities, 3) determine risk factors associated with a worse prognosis, 4) develop therapeutic strategies with goal of reducing risk factors, 5) apply acquired knowledge in public health policies focusing on preventive strategies.

scholarly journals Association of Cardiovascular Risk Factors and Metabolic Syndrome with non-alcoholic and alcoholic fatty liver disease: a retrospective analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. L. Han
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Liver Disease ◽  
Fatty Liver ◽  
Cardiovascular Risk Factors ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Healthy Group ◽  
Alcoholic Fatty Liver Disease

Abstract Background Although many studies on non-alcoholic fatty liver disease (NAFLD) are underway worldwide, and several existing studies have investigated the association between NAFLD and cardiovascular risk factors, studies comparing NAFLD and alcoholic fatty liver disease (AFLD) are scarce. This study aimed to evaluate differences between the incidence of cardiovascular risk factors and metabolic syndrome in NAFLD and AFLD. Methods A retrospective analysis of 913 patients who underwent abdominal computed tomography (CT) was performed to compare the incidence of cardiovascular risk factors and metabolic syndrome between NAFLD and AFLD. Subjects were divided into three groups based on criteria: healthy (n = 572), NAFLD (n = 295), and AFLD (n = 46). The healthy group had no liver disease. NAFLD was defined as fatty liver diagnosed on CT and drinking less than 140 g/week for men or 70 g/week for women. AFLD was defined as fatty liver diagnosed on CT and drinking more than 140 g/week for men or 70 g/week for women. We compared the incidence of cardiovascular risk factors and metabolic syndrome between the three groups. The relationship between each group and the metabolic syndrome risk was analyzed through multivariate logistic regression analysis. Results No significant differences in several cardiovascular risk factors were observed between the NAFLD and AFLD groups. Upon analyzing the metabolic syndrome status in each group after making appropriate adjustments, the odds ratios (ORs) in the NAFLD (OR = 2.397, P = 0.002) and AFLD groups (OR = 4.445, P = 0.001) were found to be significantly higher than that in the healthy group; the incidence rate of metabolic syndrome was similar in the NAFLD and AFLD groups. Conclusions Both the NAFLD and AFLD groups had more cardiovascular risk factors and higher metabolic syndrome risk than the healthy group. Thus, the prevention of fatty liver disease, regardless of the specific type, should involve the identification of cardiovascular and metabolic syndrome risk factors. If abdominal CT reveals a fatty liver, whether NAFLD or AFLD, the risk of cardiovascular disease and metabolic syndrome should be assessed.

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