title: Non-alcoholic fatty liver disease and type 2 diabetes mellitus: the liver disease of our age?
abstract: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that might affect up to one-third of the adult population in industrialised countries. NAFLD incorporates histologically and clinically different non-alcoholic entities; fatty liver (NAFL, steatosis hepatis) and steatohepatitis (NASH-characterised by hepatocyte ballooning and lobular inflammation ± fibrosis) might progress to cirrhosis and rarely to hepatocellular cancer. NAFL increasingly affects children (paediatric prevalence is 4.2%-9.6%). Type 2 diabetes mellitus (T2DM), insulin resistance (IR), obesity, metabolic syndrome and NAFLD are particularly closely related. Increased hepatic lipid storage is an early abnormality in insulin resistant women with a history of gestational diabetes mellitus. The accumulation of triacylglycerols in hepatocytes is predominantly derived from the plasma nonesterified fatty acid pool supplied largely by the adipose tissue. A few NAFLD susceptibility gene variants are associated with progressive liver disease, IR, T2DM and a higher risk for hepatocellular carcinoma. Although not approved, pharmacological approaches might be considered in NASH patients.
authors.affiliation: Gábor Firneisz, 2 Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
authors.forename: Gábor
authors.initials: G
authors.lastname: Firneisz
mesh_terms: D050154:Adiposity; D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D051048:Diacylglycerol O-Acyltransferase / Q000378:metabolism; D003952:Diagnostic Imaging / Q000379:methods; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use; D005230:Fatty Acids, Nonesterified / Q000378:metabolism; D020022:Genetic Predisposition to Disease; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D007333:Insulin Resistance; D008049:Lipase / Q000235:genetics / Q000378:metabolism; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000378:metabolism; D008565:Membrane Proteins / Q000235:genetics / Q000378:metabolism; D008930:Mitochondria, Liver / Q000378:metabolism; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D011237:Predictive Value of Tests; D015995:Prevalence; D066244:Proton Magnetic Resonance Spectroscopy; D012307:Risk Factors; D014280:Triglycerides / Q000378:metabolism; D000217:Acyltransferases; D054512:Phospholipases A2, Calcium-Independent
chemical_list: D051048:Diacylglycerol O-Acyltransferase; D054873:Dipeptidyl-Peptidase IV Inhibitors; D005230:Fatty Acids, Nonesterified; D018836:Inflammation Mediators; D008049:Lipase; D008565:Membrane Proteins; D014280:Triglycerides; C494885:DGAT2 protein, human; C533682:PNPLA3 protein, human; D000217:Acyltransferases; D054512:Phospholipases A2, Calcium-Independent
keywords: Dysfunctional adipose tissue; Genetics; Hepatocellular cancer; Insulin resistance; Liver cirrhosis; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Obesity; Therapy; Type 2 diabetes mellitus
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