scholarly journals Syndrome of increased epithelial permeability, non-alcoholic fatty liver disease and cardiovascular diseases: what is the association and what can be done about it?

2021 ◽  
Vol 2 (8) ◽  
pp. 12-19
Author(s):  
Natalia M. Vorobyeva ◽  
◽  
Olga N. Tkacheva ◽  
Keyword(s):  
Liver Disease ◽  
Cardiovascular Diseases ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Experimental Studies ◽  
Epithelial Permeability ◽  
Cardiovascular Risks ◽  
Alcoholic Fatty Liver ◽  
Cardiovascular Morbidity And Mortality ◽  
Alcoholic Fatty Liver Disease

Syndrome of increased epithelial permeability occurs due to a decrease in the barrier function of the gastrointestinal mucosa due to impaired intercellular interactions, resulting in bacterial translocation (i. e. penetration of bacteria and toxins from the gastrointestinal lumen into the bloodstream), which can initiate an inflammatory process in various diseases. Syndrome of increased epithelial permeability plays an important role in the pathogenesis of many chronic diseases, including cardiovascular and non-alcoholic fatty liver disease (NAFLD). In turn, the presence of NAFLD is associated with an increase in cardiovascular morbidity and mortality. The use of ursodeoxycholic acid in NAFLD allows reducing both hepatological and cardiovascular risks. Gastro- and enteroprotector rebamipide not only eliminates increased epithelial permeability and acts at all three levels of protection of the mucosepithelial barrier, but also has multiple pleiotropic effects, which opens up wide prospects for its use in cardiovascular diseases and NAFLD. The hepatoprotective and anti-sclerotic effects of rebamipide identified in experimental studies need further study in clinical trials in NAFLD patients.

scholarly journals Cardiovascular Diseases and Non-Alcoholic Fatty Liver Disease: Relationship and Pathogenetic Aspects of Pharmacotherapy

2022 ◽  
Vol 17 (6) ◽  
pp. 880-888
Author(s):  
A. V. Nelidova ◽  
M. A. Livzan ◽  
N. A. Nikolaev ◽  
T. S. Krolevets
Keyword(s):  
Cardiovascular Risk ◽  
Liver Disease ◽  
Cardiovascular Diseases ◽  
Liver Fibrosis ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cardiovascular Risks ◽  
Alcoholic Fatty Liver ◽  
The Impact ◽  
Alcoholic Fatty Liver Disease

The association of non-alcoholic fatty liver disease (NAFLD) and cardiovascular risk is currently one of the actively studied areas. The incidence of non-alcoholic fatty  liver disease continues to grow worldwide. In the structure of mortality rate of patients with non-alcoholic fatty  liver disease,  the first place is occupied by cardiovascular events: stroke and myocardial infarction. Studies have shown that the presence of severe liver fibrosis (F3-4) in NAFLD not only increases the risk of cardiovascular diseases (CVD), but also increases the risk  of  overall  mortality  by  69%  due  to mortality from cardiovascular causes. The degree of increased risk is associated with the degree of activity of non-alcoholic steatohepatitis (NASH). Despite the large number of works on this topic, we do not have a clear opinion on the impact on cardiovascular risk, interaction and the contribution of various factors, as well as algorithms for managing patients with non-alcoholic fatty liver disease to reduce the risk of cardiovascular diseases. This article describes the pathogenetic factors of formation of cardiovascular risks in patients with non-alcoholic fatty liver disease, proposed the idea of stratification of cardiovascular risks in these patients, taking into account changes in the structure of the liver (fibrosis) and function (clinical and biochemical activity) and also it describes the main directions of drug therapy, taking into account the common pathogenetic mechanisms for non-alcoholic fatty liver disease and cardiovascular diseases. The role of obesity, local fat depots, adipokines, and endothelial dysfunction as the leading pathogenetic factors of increased cardiovascular risk in patients with NAFLD is discussed. Among pathogenetically justified drugs in conditions of poly and comorbidity, hypolipidemic (statins, fibrates), angiotensin II receptor antagonists, beta-blockers, etc. can be considered. According to numerous studies, it becomes obvious that the assessment of cardiovascular risks in patients with NAFLD will probably allow prescribing cardiological drugs, selecting individualized therapy regimens, taking into account the form of NAFLD, and on the other hand, building curation taking into account the identified cardiovascular risks.

Non-alcoholic fatty liver disease (NAFLD) and 10-year risk of cardiovascular diseases

2017 ◽  
Vol 41 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Nima Motamed ◽  
Behnam Rabiee ◽  
Hossein Poustchi ◽  
Babak Dehestani ◽  
Gholam Reza Hemasi ◽  
...  
Keyword(s):  
Liver Disease ◽  
Cardiovascular Diseases ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

scholarly journals Risk factors of arterial hypertension in patients with nonalcoholic fatty liver disease.

2018 ◽  
Vol 96 (6) ◽  
pp. 537-543
Author(s):  
E. V. Sevostyanova ◽  
V. Ya. Polyakov ◽  
Yu. A. Nikolaev ◽  
I. M. Mitrofanov
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Density Lipoprotein ◽  
Modifiable Risk Factors ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Purpose of the study. To study frequency of occurrence and values ofparameters of the main risk factors for cardiovascular diseases in patients with hypertension in combination with non-alcoholic fatty liver disease. Material and methods. The analysis of 17,202 medical cards of patients (6,730 men, 10,472 women), which were examined and treated in the clinic of the Scientific Research Institute of Experimental and Clinical Medicine, Novosibirsk, was carried out. Of them - 3,087patients with arterial hypertension (AH), combined with non-alcoholic fatty liver disease (NAFLD) (main group); 13,384 patients with isolated arterial hypertension; 731 patients with NAFLD (comparison groups). According to the clinical and laboratory examination, the following risk factors were assessed: high blood pressure, obesity, elevated blood levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, uric acid, a low content of high-density lipoprotein cholesterol in the blood. Results. In patients with hypertension combined with NAFLD, in comparison with patients with isolated diseases, an increase in the values of the indices determining the main modifiable risk factors for cardiovascular diseases (hypertension, obesity, hyperglycemia, hypercholesterolemia, hyperuricemia) was revealed. Similar changes were detected in both men and women. Conclusion. An important role of risk factors for cardiovascular diseases, which together represent the clinical manifestations of the metabolic syndrome, has been identified in the development of comorbid pathology - AH and NAFLD. The data obtained indicate the need for differentiated, personified prevention and treatment of patients with this comorbid pathology with mandatory identification and correction of modifiable risk factors for cardiovascular diseases.

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 Features of the course of non-alcoholic fatty liver disease in HIV-infected individuals

2020 ◽  
Vol 47 (2) ◽  
pp. 66-71
Author(s):  
V. A. Akhmedov ◽  
N. F. Mamedova ◽  
A. V. Verbanov ◽  
O. V. Gaus ◽  
O. V. Gaus
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Steatosis ◽  
Experimental Studies ◽  
Rapid Progression ◽  
People Living With Hiv ◽  
Alcoholic Fatty Liver ◽  
High Prevalence ◽  
Alcoholic Fatty Liver Disease

This article reflects the course of non-alcoholic fatty liver disease (NAFLD) in HIV-infected individuals. It is noted that long-term antiretroviral therapy and the use of D-drugs can explain the high prevalence of steatosis in this category of patients. The results of experimental studies that demonstrate the direct effect of HIV on liver steatosis by infection of stellate liver cells, stimulation of abnormal expression of SREBP-1 and PPARγ are considered. The role of HIV-mediated microbial translocation as one of the triggers for the development of non-alcoholic steatohepatitis (NASH), which contributes to chronic inflammation due to an increase in the permeability of the intestinal barrier to bacterial products and endotoxins, is noted. Data are presented confirming the high prevalence of the abnormal distribution of fat and visceral obesity (components of lipodystrophy syndrome) in a cohort of HIV-infected individuals. There was a high prevalence of steatosis and steatohepatitis in HIV-infected patients with lipodystrophy as compared with HIV-infected patients without lipodystrophy. Data showing the high prevalence of NASH in HIV-infected individuals are presented. A high rate of progression of NAFLD in a cohort of HIV-infected individuals was observed, regardless of the presence/absence of a combined viral infection (chronic hepatitis C). It has been established that the classic risk factors for NAFLD (high body mass index, dyslipidemia, metabolic syndrome) can contribute to the rapid progression of the disease in people living with HIV, compared with representatives of the general population.

scholarly journals Hypolipidemic therapy in patients with non-alcoholic fatty liver disease

2010 ◽  
Vol 1 (1) ◽  
pp. 38-45
Author(s):  
L. B Lazebnik ◽  
L. A Zvenigorodskaya ◽  
N. G Samsonova ◽  
E. A Cherkasova ◽  
N. V Melnikova
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cholesterol Absorption ◽  
Atherogenic Dyslipidemia ◽  
Cardiovascular Risks ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Dyslipidemia is currently accepted to be one of the major risk factor for cardiovascular diseases and atherosclerosis. There is no question that the liver plays an important role in the development of atherogenic dyslipidemia and it is simultaneously a target organ, which results in the development of non-alcoholic fatty liver disease (NAFLD). The latter limits the feasibilities of adequate hypolipidemic therapy, thus increasing the cardiovascular risks. There is a need to use hepatoprotectors when atherogenic dyslipidemia in a patient with documented NAFLD is treated with statins and fibrates. The choice of hepatoprotectors depends on the stage of NAFLD. It is expedient to take statins in combination with ursodeoxycholic acid preparations in NAFLD at the stage of steatosis. A combination of statins and a cholesterol absorption inhibitor is more effective in achieving low-density lipoprotein cholesterol goals in patients with hypercholesterolemia. Intestinal microflora-normalizing agents (enteric antiseptics, pre- and probiotics) should be included into a complex of hypolipidemic therapy in patients with NAFLD. Key words: atherogenic dyslipidemia, non-alcoholic fatty liver disease, hypolipidemic therapy.

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