![Sample our Bioscience journals, sign in here to start your access, Latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5925/TOC-Subject-Sample-2021-Bioscience.jpg"})
Abstract
The association of metabolic disorders with liver disease is receiving increasing attention in the gastroenterological community. Cohort studies have shown that advanced liver disease may stem from metabolic disorders, via fatty liver, non‐alcoholic steatohepatitis, cryptogenic cirrhosis, and eventually hepatocellular carcinoma. In both obesity and diabetes, deaths from cirrhosis are higher than expected, mainly in subjects with no or moderate alcohol consumption, but high rates of fatty liver disease have been associated with all features of the metabolic syndrome. Also the risk of hepatocellular carcinoma is higher than normal, being dependent on body mass index (BMI) in obesity, and independent of age, BMI, gender and race in diabetes. Finally, metabolic liver disease may interact with hepatitis C virus infection, increasing the risk of steatosis and liver disease progression, as well as reducing the chances of an effective antiviral treatment. There is evidence that treatments aimed at reducing insulin resistance are also effective in improving liver histology. Although cardiovascular disease remains the major cause of increased morbidity and excess mortality in metabolic disorders, the risk of progressive liver disease should no longer be underestimated, being a threat to millions of people at risk in the present epidemics of obesity and diabetes, and therapeutic strategies need to be tested.
| Abbreviations | ||
| ALF | = | acute liver failure |
| ALT | = | alanine aminotransferase |
| AR | = | attributable risk |
| AST | = | aspartate aminotransferase |
| BMI | = | body mass index |
| CC | = | cryptogenic cirrhosis |
| CI | = | confidence interval |
| DM | = | diabetes mellitus |
| FFA | = | free fatty acids |
| GGT | = | gamma‐glutamyltransferase |
| HBV | = | hepatitis B virus |
| HCC | = | hepatocellular carcinoma |
| HCV | = | hepatitis C virus |
| HR | = | hazard ratio |
| ICD‐9 | = | international classification of diseases (9th edition) |
| IRS‐1 | = | insulin receptor substrate‐1 |
| MS | = | metabolic syndrome |
| NAFLD | = | non‐alcoholic fatty liver disease |
| NASH | = | non‐alcoholic steatohepatitis |
| OR | = | odds ratio |
| PI‐3K | = | phosphatidyl inosytol‐3 kinase |
| PPAR | = | peroxisome‐proliferator activated receptor |
| RR | = | relative risk |
| SIR | = | standardized incidence ratio |
| SMR | = | standardized mortality rate |
| T2DM | = | type 2 diabetes mellitus |
| TNF | = | tumor necrosis factor |
| Abbreviations | ||
| ALF | = | acute liver failure |
| ALT | = | alanine aminotransferase |
| AR | = | attributable risk |
| AST | = | aspartate aminotransferase |
| BMI | = | body mass index |
| CC | = | cryptogenic cirrhosis |
| CI | = | confidence interval |
| DM | = | diabetes mellitus |
| FFA | = | free fatty acids |
| GGT | = | gamma‐glutamyltransferase |
| HBV | = | hepatitis B virus |
| HCC | = | hepatocellular carcinoma |
| HCV | = | hepatitis C virus |
| HR | = | hazard ratio |
| ICD‐9 | = | international classification of diseases (9th edition) |
| IRS‐1 | = | insulin receptor substrate‐1 |
| MS | = | metabolic syndrome |
| NAFLD | = | non‐alcoholic fatty liver disease |
| NASH | = | non‐alcoholic steatohepatitis |
| OR | = | odds ratio |
| PI‐3K | = | phosphatidyl inosytol‐3 kinase |
| PPAR | = | peroxisome‐proliferator activated receptor |
| RR | = | relative risk |
| SIR | = | standardized incidence ratio |
| SMR | = | standardized mortality rate |
| T2DM | = | type 2 diabetes mellitus |
| TNF | = | tumor necrosis factor |