Journal
WORLD JOURNAL OF GASTROENTEROLOGY
Volume 21, Issue 22, Pages 6820-6834Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v21.i22.6820
Keywords
Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Cardiovascular disease; Liver fibrosis; Statins; Chronic kidney disease; Arterial stiffness; Inflammation
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Funding
- Merck, Sharp and Dohme
- AstraZeneca
- Genzyme
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Non-alcoholic fatty liver disease (NAFLD) is considered to be an independent cardiovascular disease (CVD) risk factor. However, simple steatosis has a benign clinical course without excess mortality. In contrast, the advanced form of NAFLD, non-alcoholic steatohepatitis (NASH) with liver fibrosis increases mortality by approximately 70%, due to an increase in CVD mortality by approximately 300%. Chronic kidney disease (CKD) may be caused by NAFLD/NASH and it substantially increases CVD risk, especially in the presence of type 2 diabetes mellitus. Moreover, CKD may trigger NAFLD/NASH deterioration in a vicious cycle. NAFLD/NASH is also related to increased arterial stiffness (AS), an independent CVD risk factor that further raises CVD risk. Diagnosis of advanced liver fibrosis (mainly by simple non-invasive tests), CKD, and increased AS should be made early in the course of NAFLD and treated appropriately. Lifestyle measures and statin treatment may help resolve NAFLD/NASH and beneficially affect the CVD risk factors mentioned above.
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