Journal
EUROPEAN HEART JOURNAL
Volume 33, Issue 10, Pages 1190-+Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehr453
Keywords
Non-alcoholic fatty liver disease; Cardiovascular disease; Insulin resistance; Risk factor; Ectopic fat
Categories
Funding
- Southampton NIHR Biomedical Research Unit in Nutrition, Lifestyle, and Obesity
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Non-alcoholic fatty liver disease (NAFLD) affects up to a third of the population worldwide and may confer increased cardiometabolic risk with consequent adverse cardiovascular outcomes independent of traditional cardiovascular risk factors and the metabolic syndrome. It is characterized almost universally by insulin resistance and is strongly associated with type 2 diabetes and obesity. Non-alcoholic fatty liver disease is a marker of pathological ectopic fat accumulation combined with a low-grade chronic inflammatory state. This results in several deleterious pathophysiological processes including abnormal glucose, fatty acid and lipoprotein metabolism, increased oxidative stress, deranged adipokine profile, hypercoaguability, endothelial dysfunction, and accelerated progression of atherosclerosis. This ultimately leads to a dysfunctional cardiometabolic phenotype with cardiovascular mortality representing the main mode of premature death in NAFLD. This review is aimed at introducing NAFLD to the clinical cardiologist by discussing in-depth the evidence to date linking NAFLD with cardiovascular disease, reviewing the likely mechanisms underlying this association, as well as summarizing from a cardiologists perspective, current and potential future treatment options for this increasingly prevalent disease.
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