title: Pathogenesis of hepatic steatosis: the link between hypercortisolism and non-alcoholic fatty liver disease.
abstract: Based on the available literature, non alcoholic fatty liver disease or generally speaking, hepatic steatosis, is more frequent among people with diabetes and obesity, and is almost universally present amongst morbidly obese diabetic patients. Non alcoholic fatty liver disease is being increasingly recognized as a common liver condition in the developed world, with non alcoholic steatohepatitis projected to be the leading cause of liver transplantation. Previous data report that only 20% of patients with Cushing's syndrome have hepatic steatosis. Aiming at clarifying the reasons whereby patients suffering from Cushing's syndrome - a condition characterized by profound metabolic changes - present low prevalence of hepatic steatosis, the Authors reviewed the current concepts on the link between hypercortisolism and obesity/metabolic syndrome. They hypothesize that this low prevalence of fat accumulation in the liver of patients with Cushing's syndrome could result from the inhibition of the so-called low-grade chronic-inflammation, mainly mediated by Interleukin 6, due to an excess of cortisol, a hormone characterized by an anti-inflammatory effect. The Cushing's syndrome, speculatively considered as an in vivo model of the hepatic steatosis, could also help clarify the mechanisms of non alcoholic fatty liver disease.
authors.affiliation: Giovanni Tarantino, Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, 80131 Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tarantino
authors.forename: Carmine
authors.initials: C
authors.lastname: Finelli
mesh_terms: D042842:11-beta-Hydroxysteroid Dehydrogenases / Q000378:metabolism; D000273:Adipose Tissue / Q000378:metabolism; D000818:Animals; D003480:Cushing Syndrome / Q000453:epidemiology* / Q000378:metabolism; D005234:Fatty Liver / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D018836:Inflammation Mediators / Q000378:metabolism; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000378:metabolism; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000378:metabolism; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism; D015995:Prevalence
chemical_list: D018836:Inflammation Mediators; D015850:Interleukin-6; D042842:11-beta-Hydroxysteroid Dehydrogenases; D006854:Hydrocortisone
keywords: Cushing’s syndrome; Hypercotisolism; Nonalcoholic fatty liver disease