Search

NAFLD, cardiovascular disease (CVD) and chronic kidney disease (CKD) are thought to be linked. However, whether NAFLD is a marker of, or a causal risk factor for, CVD and CKD is unclear. In this Review, Enzo Bonora and Giovanni Targher discuss the key pitfalls and main certainties surrounding the associations between these diseases.

Cardiovascular disease is the leading cause of death in NAFLD. In this Review, the authors explore the evidence that NAFLD affects not only the coronary arteries but also all other cardiac structures, thereby potentially increasing risk of cardiomyopathy, cardiac arrhythmias, conduction defects and valvular calcification.

Spatially resolved transcriptomic, metabolomic and proteomic analyses of human liver samples highlight the role of lipid-associated macrophages in metabolic dysfunction-associated steatotic liver disease.

Non-alcoholic fatty liver disease (NAFLD) not only affects the liver, but can also increase the risk of developing extra-hepatic diseases, including type 2 diabetes mellitus, cardiovascular disease and chronic kidney disease (CKD). Here, Targher and Byrne discuss the epidemiologic and mechanistic evidence of a pathogenic link between NAFLD and CKD.

Obesity is a risk factor for several noncommunicable diseases, but some individuals with obesity remain metabolically healthy throughout life; whether these individuals are at risk of developing NAFLD is uncertain. In a new study, Chang et al. showed a statistically significant, graded relationship between BMI and NAFLD in metabolically healthy individuals.

NAFLD is becoming much more common, and will soon be the major underlying aetiology for liver transplantation. This article discusses the evidence that NAFLD is a multisystem disease and outlines the factors that determine interindividual variation in the development and progression of NAFLD.

Steatotic liver disease has emerged as an important risk factor for cardiovascular disease, type 2 diabetes mellitus and chronic kidney disease. Successful treatment of steatotic liver disease might also be effective in preventing these cardiometabolic diseases.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a heterogeneous disease regarding its pathophysiology and clinical outcomes. Two novel studies suggest that different clusters of people with MASLD exist, explaining part of this heterogeneity. These findings and future research applying data dimensionality reduction approaches might be beneficial for implementing precision medicine in MASLD.

Glucagon-like peptide 1 receptor agonists are effective pharmacotherapies for the treatment of obesity and related disorders. In metabolic dysfunction-associated steatohepatitis with moderate to advanced fibrosis, semaglutide improved liver histology over 72 weeks. In another new study, tirzepatide was superior to semaglutide in reducing body weight in individuals with obesity.

There is growing recognition of the metabolic links between metabolic dysfunction-associated steatotic liver disease (MASLD) and sarcopenia and the need to take these links into account when diagnosing and treating these two diseases. This Review covers connections between MASLD, sarcopenia and metabolic syndrome and discusses how care for patients affected by these diseases is evolving.

Zhang and Gu used four cohorts to examine associations between skeletal muscle strength (SMS) and chronic kidney disease (CKD) in people with metabolic dysfunction-associated steatotic liver disease (MASLD). Higher handgrip/muscle strength is closely associated with a lower prevalence and incidence of CKD in people with MASLD.

Pathological arterial thrombosis represents the most-frequent cause of death worldwide. Dr. Lippi and colleagues explain the molecular and cellular mechanisms involved in atherothrombosis, and discuss genetic and acquired risk factors associated with this condition.

This Review outlines the occurrence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH) in patients who have undergone liver transplantation for prior NASH-related cirrhosis (recurrent) or other liver indications (de novo).

This Review describes the evidence of an association and causal link between nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM), discusses their pathophysiological mechanisms and summarizes the pharmacological treatments that might benefit or adversely affect the risk of T2DM or NAFLD progression.

Advances have been made in the field of nonalcoholic fatty liver disease in 2019. One paper highlights the role of gut microbiota in hepatocellular carcinoma (HCC) pathogenesis, another presents a noninvasive algorithm for detecting advanced liver fibrosis and another suggests a potential novel approach to treating nonalcoholic steatohepatitis and suppressing HCC development.

This Review focuses on the adverse effect of nonalcoholic fatty liver disease (NAFLD) on the risk of chronic vascular complications of diabetes mellitus. The putative pathophysiological mechanisms by which NAFLD might contribute to the development and progression of chronic vascular complications of diabetes mellitus are also discussed, and the principles of NAFLD treatment are critically evaluated.

‘Metabolic dysfunction-associated fatty liver disease’ has been proposed as a replacement term for ‘Non-alcoholic fatty liver disease’, in part to recognize the fact that this liver disease occurs within a series of complex metabolic disorders. This Perspective article discusses the clinical associations and pathophysiological mechanisms underpinning the relationship between metabolic dysfunction-associated fatty liver disease and chronic kidney disease.