Hypertension, diabetes, atherosclerosis and NASH: Cause or consequence?

Area of Science:

• Hepatology
• Cardiology
• Endocrinology

Background:

• Non-alcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition with rising global incidence.
• NAFLD is increasingly recognized as a contributor to, rather than merely a consequence of, metabolic syndrome (MetS).
• The adverse effects of NAFLD extend beyond the liver, impacting cardiometabolic health.

Purpose of the Study:

• To critically review the clinical evidence supporting a bidirectional relationship between NAFLD and MetS components.
• To examine the association between NAFLD severity and the risk of developing type 2 diabetes mellitus (T2DM), hypertension (HTN), and cardiovascular disease (CVD).
• To discuss the biological mechanisms linking NAFLD to HTN, T2DM, and CVD.

Main Methods:

• Review of existing clinical evidence and prospective studies.
• Analysis of the association between NAFLD presence/severity and cardiometabolic disease incidence.
• Exploration of proposed biological pathways connecting NAFLD to MetS components.

Main Results:

• NAFLD severity is directly correlated with an increased risk of developing T2DM and HTN.
• NAFLD independently predicts fatal and nonfatal CVD events.
• A complex, bidirectional relationship exists between NAFLD and MetS components like T2DM and HTN.

Conclusions:

• NAFLD plays a significant role in the pathogenesis of T2DM, HTN, and CVD.
• Understanding the mechanisms underlying NAFLD's impact on cardiometabolic health is crucial for prevention and treatment.
• Further research into the bidirectional interactions between NAFLD and MetS is warranted.