NAFLD and cardiovascular risk factors: implications for vascular disease. [Book Chapter]

In recent years, the potential prognostic role for nonalcoholic fatty liver disease (NAFLD) in the development of cardiovascular disease (CVD) has attracted considerable interest. Growing evidence suggests that NAFLD, especially in its necro-inflammatory form (NASH), is associated with an increased prevalence and incidence of CVD, independently of obesity and other shared cardiometabolic risk factors. These findings suggest that NAFLD is not simply a marker of CVD, but that this condition may also be involved in CVD pathogenesis, possibly through the systemic release of several proatherogenic mediators from the steatotic and inflamed liver or through the contribution of NAFLD to systemic/hepatic insulin resistance and atherogenic dyslipidemia. However, given the heterogeneity and the relatively small number of observational studies, further research is needed to corroborate the prognostic value of NAFLD in the development and progression of CVD, and to further elucidate the complex and intertwined mechanisms linking NAFLD and CVD.