title: Cardiovascular risk, lipidemic phenotype and steatosis. A comparative analysis of cirrhotic and non-cirrhotic liver disease due to varying etiology.
abstract: BACKGROUND
  Liver regulates lipid metabolism in health and disease states. Nevertheless, the entity of cardiovascular risk (CVR) resulting from dysregulation of lipid metabolism secondary to liver disease is poorly characterized.
  
  
  OBJECTIVE
  To review, based on a PubMed literature search, the features and the determinants of serum lipid phenotype and its correlation with hepatic steatosis, insulin resistance (IR) and CVR across the wide spectrum of the most common chronic liver diseases due to different etiologies.
  
  
  RESULTS
  Alcoholic liver disease (ALD) is associated with steatosis, IR and a typical lipid profile. The relationship between alcohol intake, incident type 2 diabetes (T2D) and CVR describes a J-shaped curve. Non-alcoholic fatty liver disease (NAFLD), and probably nonalcoholic steatohepatitis (NASH) in particular, is associated with IR, atherogenic dyslipidemia and increased CVR independent of traditional risk factors. Moreover, NASH-cirrhosis and T2D contribute to increasing CVR in liver transplant recipients. HBV infection is generally free from IR, steatosis and CVR. HCV-associated dysmetabolic syndrome, featuring steatosis, hypocholesterolemia and IR, appears to be associated with substantially increased CVR. Hyperlipidemia is an almost universal finding in primary biliary cirrhosis, a condition typically spared from steatosis and associated with neither subclinical atherosclerosis nor excess CVR. Finally, little is known on CVR in patients with hepatocellular carcinoma.
  
  
  CONCLUSIONS
  CVR is increased in ALD, NAFLD and chronic HCV infection, all conditions featuring IR and steatosis. Therefore, irrespective of serum lipid phenotype, hepatic steatosis and IR may be major shared determinants in amplifying CVR in common liver disease due to varying etiology.
authors.affiliation: University of Modena and Reggio Emilia, Italy; Azienda USL MODENA, Italy. Electronic address: paola.loria@unimore.it.
authors.forename: P
authors.initials: P
authors.lastname: Loria
authors.affiliation: University of Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Marchesini
authors.affiliation: University of Modena and Reggio Emilia, Italy; Azienda USL MODENA, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Nascimbeni
authors.affiliation: University of Modena and Reggio Emilia, Italy; Azienda USL MODENA, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ballestri
authors.affiliation: University of Modena and Reggio Emilia, Italy; Azienda USL MODENA, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Maurantonio
authors.affiliation: University of Modena and Reggio Emilia, Italy; Azienda USL MODENA, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Carubbi
authors.affiliation: INSERM Salpetriere, France.
authors.forename: V
authors.initials: V
authors.lastname: Ratziu
authors.affiliation: University of Modena and Reggio Emilia, Italy; Azienda USL MODENA, Italy. Electronic address: a.lonardo@ausl.mo.it.
authors.forename: A
authors.initials: A
authors.lastname: Lonardo
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000145:classification; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications*; D005234:Fatty Liver / Q000097:blood / Q000150:complications*; D006509:Hepatitis B / Q000097:blood / Q000150:complications; D006526:Hepatitis C / Q000097:blood / Q000150:complications; D006801:Humans; D007333:Insulin Resistance; D050356:Lipid Metabolism; D008055:Lipids / Q000097:blood*; D008099:Liver / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications*; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000150:complications; D008108:Liver Diseases, Alcoholic / Q000097:blood / Q000150:complications; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications; D065626:Non-alcoholic Fatty Liver Disease; D010641:Phenotype; D012307:Risk Factors
chemical_list: D008055:Lipids
keywords: Alcoholic liver disease; Cardiovascular risk; Cirrhosis; Hepatitis B virus; Hepatitis C virus; Hepatocellular carcinoma; Lipoproteins; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Primary biliary cirrhosis; Serum cholesterol; Serum triglycerides; Steatosis