Associated metabolic fatty liver disease and cardiovascular pathology – double causal connection
Keywords:
metabolic-associated fatty liver disease, cardiovascular disease, heart failureAbstract
The accumulation of neutral lipids in the cytoplasm of liver cells favors the onset of insulin resistance, the accumulation of lipotoxic metabolites and bile acids in hepatocytes, oxidative stress, the release of cytokines and other inflammatory mediators, as well as the intestinal microbiota, are considered to promote the transition from steatosis to inflammation liver damage and fibrosis through mitochondrial dysfunction, endoplasmic reticulum stress, cell death and immune cell infiltration. These processes are the key factor in explaining the associations between fatty liver disease, metabolic diseases and cardiovascular diseases. Results. The presence of metabolic-associated fatty liver disease (MAFLD) is associated with increased cardiovascular (CV) risk, which is why appropriate management is necessary to improve the outcome of CV diseases and of hepatic ones. According to the recent statements of the American Cardiology Association, MAFLD should be considered as a marker of risk and worsening of cardiovascular pathologies. Conclusions. Currently, there are insufficient data to categorize MAFLD as a CV risk factor because its impact on risk has not been quantified, although MAFLD has been shown to have an additional negative impact on atherosclerotic CV disease risk (ACVDF), in addition to traditional risk factors (such as age, sex, family history of CVD, obesity, DM, hypertension, dyslipidemia, and smoking). Furthermore, studies demonstrating ACVDF reduction as a result of MAFLD treatment are not yet available, but they are essential in integrating an element as a risk factor.
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