scholarly journals The Role of Insulin Resistance and Diabetes in Nonalcoholic Fatty Liver Disease

2020 ◽  
Vol 21 (11) ◽  
pp. 3863 ◽  
Author(s):  
Hideki Fujii ◽  
Norifumi Kawada ◽  
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Hepatic Fibrosis ◽  
Fatty Liver Disease ◽  
Molecular Mechanisms ◽  
Stellate Cell ◽  
Nonalcoholic Fatty Liver ◽  
The Relationship

Nonalcoholic fatty liver disease (NAFLD) consists of the entire spectrum of fatty liver disease in patients without significant alcohol consumption, ranging from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) to cirrhosis, with NASH recently shown as an important cause of hepatocellular carcinoma (HCC). There is a close relationship between insulin resistance (IR) and NAFLD, with a five-fold higher prevalence of NAFLD in patients with type 2 diabetes (T2DM) compared to that in patients without T2DM. IR is involved in the progression of disease conditions such as steatosis and NASH, as well as hepatic fibrosis progression. The mechanisms underlying these processes involve genetic factors, hepatic fat accumulation, alterations in energy metabolism, and inflammatory signals derived from various cell types including immune cells. In NASH-associated fibrosis, the principal cell type responsible for extracellular matrix production is the hepatic stellate cell (HSC). HSC activation by IR involves “direct” and “indirect” pathways. This review will describe the molecular mechanisms of inflammation and hepatic fibrosis in IR, the relationship between T2DM and hepatic fibrosis, and the relationship between T2DM and HCC in patients with NAFLD.

scholarly journals Molecular Mechanisms: Connections between Nonalcoholic Fatty Liver Disease, Steatohepatitis and Hepatocellular Carcinoma

2020 ◽  
Vol 21 (4) ◽  
pp. 1525 ◽  
Author(s):  
Tatsuo Kanda ◽  
Taichiro Goto ◽  
Yosuke Hirotsu ◽  
Ryota Masuzaki ◽  
Mitsuhiko Moriyama ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Hepatic Fibrosis ◽  
Fatty Liver Disease ◽  
Molecular Mechanisms ◽  
Bacterial Overgrowth ◽  
Sequence Variant ◽  
Nonalcoholic Fatty Liver

Nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH), causes hepatic fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The patatin-like phospholipase-3 (PNPLA3) I148M sequence variant is one of the strongest genetic determinants of NAFLD/NASH. PNPLA3 is an independent risk factor for HCC among patients with NASH. The obesity epidemic is closely associated with the rising prevalence and severity of NAFLD/NASH. Furthermore, metabolic syndrome exacerbates the course of NAFLD/NASH. These factors are able to induce apoptosis and activate immune and inflammatory pathways, resulting in the development of hepatic fibrosis and NASH, leading to progression toward HCC. Small intestinal bacterial overgrowth (SIBO), destruction of the intestinal mucosa barrier function and a high-fat diet all seem to exacerbate the development of hepatic fibrosis and NASH, leading to HCC in patients with NAFLD/NASH. Thus, the intestinal microbiota may play a role in the development of NAFLD/NASH. In this review, we describe recent advances in our knowledge of the molecular mechanisms contributing to the development of hepatic fibrosis and HCC in patients with NAFLD/NASH.

scholarly journals NONALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH CORONARY DISEASE FROM A BRAZIL NORTHEAST AREA

2015 ◽  
Vol 52 (2) ◽  
pp. 111-116 ◽  
Author(s):  
Consuêlo Padilha VILAR ◽  
Helma Pinchemel COTRIM ◽  
Gesira Soares Assis FLORENTINO ◽  
Gerson BRAGAGNOLI ◽  
Paulo Adriano SCHWINGEL ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Regression Analysis ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Multivariate Regression Analysis ◽  
Nonalcoholic Fatty Liver ◽  
The Relationship

Background Nonalcoholic fatty liver disease (NAFLD) is the most frequent chronic liver injury around the world. It is associated with metabolic syndrome and cardiovascular diseases. Objective To evaluate the frequency and relevance of NAFLD in patients with coronary artery disease (CAD). Methods Patients from a Brazil Northeast area, who underwent elective coronary angiography (CAG) from 2009 to 2010 were included. All of them had suspicion of CAD. Criteria to CAD: presence of obstructive lesions in the epicardial coronary arteries, or in their major branches. NAFLD criteria: presence of hepatic steatosis on ultrasound; exclusion of other liver diseases; ethanol intake ≤ 20g/day. Statistics analysis included Independent t-test, Mann-Whitney and Pearson’s chi-squared test. Multivariate regression analysis measured the relationship between the risk factors and the concomitant presence of CAD and NAFLD. Results A total of 244 patients were evaluated: 63.5% had CAD and 42.2% had NAFLD. NAFLD was observed in 43.9% of the CAD patients. The regression analysis showed that the relationship between CAD and NAFLD was positively correlated with HOMA-IR ≥3.0 or insulin resistance and overweight/obesity. Conclusion NAFLD was frequent among CAD patients; insulin resistance and overweight/obesity were the most relevant risk factors related to the association NAFLD and CAD. The results suggest that patients with CAD should be evaluated for NAFLD.

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