Boala ficatului gras metabolic asociat și patologia cardiovasculară – conexiune cu dublă cauzalitate

Irina Cabac-Pogorevici; Inessa Jitari; Dmitri Savca; Valeriu Revenco

Autori

Irina Cabac-Pogorevici Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0000-0001-9813-6763
Inessa Jitari IMSP Institutul de Cardiologie https://orcid.org/0009-0001-2452-0356
Dmitri Savca Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0009-0003-2636-4873
Valeriu Revenco Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0000-0002-9419-025X

Cuvinte cheie:

boala ficatului gras metabolic asociat, patologie cardiovasculară, insuficienţă cardiacă

Rezumat

Acumularea de lipide neutre în citoplasma celulelor hepatice favorizează apariția insulino-rezistenței, acumularea de metaboliți lipotoxici și acizi biliari în hepatocite, stresul oxidativ, eliberarea de citokine și alți mediatori inflamatori, precum și microbiota intestinală, se consideră că promovează tranziția de la steatoză la inflamația hepatică și fibroză prin disfuncție mitocondrială, stresul reticulului endoplasmatic, moartea celulelor și infiltrarea cu celule imune. Aceste procese comlexe constituie factorul cheie în explicarea asocierilor dintre boala ficatului gras, afecțiunile metabolice și bolile cardiovasculare. Rezultate. Prezența bolii ficatului gras metabolic asociat (BFMGA) este stâns legată de creșterea riscului cardiovascular (CV), fapt ce subliniază necesitatea unui management corespunzător pentru a îmbunătăți rezultatul bolilor CV și al celor hepatice. Conform afirmațiilor recente ale Asociației Americane de Cardiologie, BFMGA ar fi considerată ca un marker de risc și de agravare a patologiilor cardiovasculare. Concluzii. În prezent, nu există suficiente date pentru a clasifica BFMGA ca un factor de risc CV bine definit, deoarece impactul său asupra riscului nu a fost cuantificat numeric. Totuși, cercetările au demonstrat că BFMGA contribuie semnificativ la creșterea riscului de boli CV aterosclerotice (BCVAS), în adiție față de factorii de risc tradiționali (cum ar fi vârsta, sexul, antecedentele familiale de BCV, obezitatea, diabetul zaharat, hipertensiunea, dislipidemia și fumatul). În plus, studiile care să demonstreze reducerea riscului de BCVAS ca urmare a tratamentului BFMGA nu sunt încă disponibile, dar acestea sunt esențiale în integrarea unui element ca factor de risc.

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https://doi.org/10.3350/cmh.2020.0137