Nonalcoholic Fatty Liver Disease and the Heart: JACC State-of-the-Art Review

J Am Coll Cardiol. 2019 Mar 5;73(8):948-963. doi: 10.1016/j.jacc.2018.11.050.

Abstract

Nonalcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD) are both manifestations of end-organ damage of the metabolic syndrome. Through multiple pathophysiological mechanisms, CVD and NAFLD are associated with each other. Systemic inflammation, endothelial dysfunction, hepatic insulin resistance, oxidative stress, and altered lipid metabolism are some of the mechanisms by which NAFLD increases the risk of CVD. Patients with NAFLD develop increased atherosclerosis, cardiomyopathy, and arrhythmia, which clinically result in cardiovascular morbidity and mortality. Defining the mechanisms linking these 2 diseases offers the opportunity to further develop targeted therapies. The aim of this comprehensive review is to examine the association between CVD and NAFLD and discuss the overlapping management approaches.

Keywords: cardiovascular disease; metabolic syndrome; nonalcoholic fatty liver disease.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / metabolism
  • Global Health
  • Humans
  • Morbidity / trends
  • Non-alcoholic Fatty Liver Disease / complications*
  • Non-alcoholic Fatty Liver Disease / metabolism
  • Oxidative Stress*
  • Risk Factors