THE PATHOGENESIS OF NON-ALCOHOLIC FATTY LIVER DISEASE IS CLOSELY RELATED TO THE METABOLIC SYNDROME COMPONENTS

Abstract

Non-alcoholic fatty liver disease (NAFLD) is closely associated with all features of the metabolic syndrome (MS). This strongly supports the notion that NAFLD may be the hepatic manifestation of the MS. NAFLD is currently the most common cause of abnormal liver function tests and affects approximatively 15-25% of the general population. NAFLD covers a spectrum of liver disease, from steatosis to non- alcoholic steatohepatitis (NASH) and cirrhosis. Insulin resistance (IR) has central etiologic roles in the development of MS and NAFLD, usually related to obesity. MS is frequently associated with chronic inflammation, having as principal mediators the adipocytokines and free fatty acids (FFA), but also CRP, TNF-a and IL-6. Chronic inflammation results in more IR and lipolysis of adipose tissue triglyceride stores, in enhanced hepatic glucose and VLDL production. The steatotic liver is thought to be vulnerable to secondary injuries including adipocytokines, mitochondrial dysfunctions, oxidative stress which lead to hepatocellular inflammation and fibrosis.