Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of progressive liverdisease encompassing simple steatosis, nonalcoholic steatohepatitis (NASH), fibrosis,and, ultimately, cirrhosis. NAFLD is strongly associated with features of the metabolicsyndrome including abdominal overweight/obesity, hypertension, atherogenic dyslipidemia,glucose intolerance, or type 2 diabetes. With the advent of increasinglysedentary lifestyles and changing dietary patterns, the prevalence of obesity andinsulin resistance has increased and, with this, NAFLD has rapidly become the mostcommon cause of chronic liver disease in many developed countries. Importantly,accumulating evidence indicates that NAFLD is strongly associated with a prothrombotictendency, which may, at least in part, contribute to the increased risk ofatherothrombotic events observed in these patients. NAFLD, especially in its necroinflammatoryform (NASH), releases a variety of proinflammatory and prothromboticmediators that play important roles in the development and progression of acuteatherothrombotic complications. NAFLD also exacerbates systemic and hepatic insulinresistance and causes atherogenic dyslipidemia. The purpose of this review is to brieflydiscuss the epidemiology and diagnosis of NAFLD, to summarize the rapidly expandingbody of evidence that supports a strong association between NAFLD and variousdisorders of coagulation and fibrinolysis and their implications for the development ofatherothrombotic complications, and to discuss some of the treatment options thatmay influence both NAFLD and its related vascular complications.

Diagnosis and management of nonalcoholic fatty liver disease and its hemostatic/thrombotic and vascular complications. [Review]

TARGHER, Giovanni;
2013

Abstract

Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of progressive liverdisease encompassing simple steatosis, nonalcoholic steatohepatitis (NASH), fibrosis,and, ultimately, cirrhosis. NAFLD is strongly associated with features of the metabolicsyndrome including abdominal overweight/obesity, hypertension, atherogenic dyslipidemia,glucose intolerance, or type 2 diabetes. With the advent of increasinglysedentary lifestyles and changing dietary patterns, the prevalence of obesity andinsulin resistance has increased and, with this, NAFLD has rapidly become the mostcommon cause of chronic liver disease in many developed countries. Importantly,accumulating evidence indicates that NAFLD is strongly associated with a prothrombotictendency, which may, at least in part, contribute to the increased risk ofatherothrombotic events observed in these patients. NAFLD, especially in its necroinflammatoryform (NASH), releases a variety of proinflammatory and prothromboticmediators that play important roles in the development and progression of acuteatherothrombotic complications. NAFLD also exacerbates systemic and hepatic insulinresistance and causes atherogenic dyslipidemia. The purpose of this review is to brieflydiscuss the epidemiology and diagnosis of NAFLD, to summarize the rapidly expandingbody of evidence that supports a strong association between NAFLD and variousdisorders of coagulation and fibrinolysis and their implications for the development ofatherothrombotic complications, and to discuss some of the treatment options thatmay influence both NAFLD and its related vascular complications.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11562/519150
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