Diabetes Metab J.  2017 Dec;41(6):430-437. 10.4093/dmj.2017.41.6.430.

Non-Alcoholic Fatty Liver Disease: The Emerging Burden in Cardiometabolic and Renal Diseases

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
  • 2Graduate School, Yonsei University College of Medicine, Seoul, Korea. yholee@yuhs.ac
  • 3Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Abstract

As the number of individuals with non-alcoholic fatty liver disease (NAFLD) has increased, the influence of NAFLD on other metabolic diseases has been highlighted. Accumulating epidemiologic evidence indicates that NAFLD not only affects the liver but also increases the risk of extra-hepatic diseases such as type 2 diabetes mellitus, metabolic syndrome, dyslipidemia, hypertension, cardiovascular or cerebrovascular diseases, and chronic kidney disease. Non-alcoholic steatohepatitis, an advanced type of NAFLD, can aggravate these inter-organ relationships and lead to poorer outcomes. NAFLD induces insulin resistance and exacerbates systemic chronic inflammation and oxidative stress, which leads to organ dysfunction in extra-hepatic tissues. Although more research is needed to identify the pathophysiological mechanisms and causal relationship between NAFLD and cardiometabolic and renal diseases, screening for heart, brain, and kidney diseases, risk assessment for diabetes, and a multidisciplinary approach for managing these patients should be highly encouraged.

Keyword

Arrhythmias, cardiac; Atherosclerosis; Diabetes mellitus; Hypertension; Insulin resistance; Metabolism; Non-alcoholic fatty liver disease; Obesity; Renal insufficiency; Stroke

MeSH Terms

Arrhythmias, Cardiac
Atherosclerosis
Brain
Cerebrovascular Disorders
Diabetes Mellitus
Diabetes Mellitus, Type 2
Dyslipidemias
Fatty Liver
Heart
Humans
Hypertension
Inflammation
Insulin Resistance
Kidney Diseases
Liver
Mass Screening
Metabolic Diseases
Metabolism
Non-alcoholic Fatty Liver Disease*
Obesity
Oxidative Stress
Renal Insufficiency
Renal Insufficiency, Chronic
Risk Assessment
Stroke

Figure

  • Fig. 1 Putative pathophysiologic mechanisms and associations between non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) and cardiometabolic and renal diseases. preDM, prediabetes mellitus; T2DM, type 2 diabetes mellitus; MetS, metabolic syndrome; HTN, hypertension; CKD, chronic kidney disease; CVD, cardiovascular disease.


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Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis
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The Leg Fat to Total Fat Ratio Is Associated with Lower Risks of Non-Alcoholic Fatty Liver Disease and Less Severe Hepatic Fibrosis: Results from Nationwide Surveys (KNHANES 2008–2011)
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