Review article: the metabolic syndrome and non-alcoholic fatty liver disease.
Metabolic syndrome represents a common risk factor for premature cardiovascular disease and cancer whose core cluster includes diabetes, hypertension, dyslipidaemia and obesity. The liver is a target organ in metabolic syndrome patients in which it manifests itself with non-alcoholic fatty liver disease spanning steatosis through hepatocellular carcinoma via steatohepatitis and cirrhosis. Given that metabolic syndrome and non-alcoholic fatty liver disease affect the same insulin-resistant patients, not unexpectedly, there are amazing similarities between metabolic syndrome and non-alcoholic fatty liver disease in terms of prevalence, pathogenesis, clinical features and outcome. The available drug weaponry for metabolic syndrome includes aspirin, metformin, peroxisome proliferator-activated receptor agonists, statins, ACE (angiotensin I-converting enzyme) inhibitors and sartans, which are potentially or clinically useful also to the non-alcoholic fatty liver disease patient. Studies are needed to highlight the grey areas in this topic. Issues to be addressed include: diagnostic criteria for metabolic syndrome; nomenclature of non-alcoholic fatty liver disease; enlargement of the clinical spectrum and characterization of the prognosis of insulin resistance-related diseases; evaluation of the most specific clinical predictors of metabolic syndrome/non-alcoholic fatty liver disease and assessment of their variability over the time; characterization of the importance of new risk factors for metabolic syndrome with regard to the development and progression of non-alcoholic fatty liver disease.
Loria
P
P
University of Modena and Reggio Emilia, Modena, Italy. loria.paola@unimore.it
Lonardo
A
A
Carulli
L
L
Verrone
A M
AM
Ricchi
M
M
Lombardini
S
S
Rudilosso
A
A
Ballestri
S
S
Carulli
N
N
D002318:Cardiovascular Diseases / Q000209:etiology; D005234:Fatty Liver / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008103:Liver Cirrhosis / Q000209:etiology; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D009369:Neoplasms / Q000401:mortality; D012307:Risk Factors