title: Cardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease: An update.
abstract: Non-alcoholic fatty liver disease (NAFLD) is considered to be an independent cardiovascular disease (CVD) risk factor. However, simple steatosis has a benign clinical course without excess mortality. In contrast, the advanced form of NAFLD, non-alcoholic steatohepatitis (NASH) with liver fibrosis increases mortality by approximately 70%, due to an increase in CVD mortality by approximately 300%. Chronic kidney disease (CKD) may be caused by NAFLD/NASH and it substantially increases CVD risk, especially in the presence of type 2 diabetes mellitus. Moreover, CKD may trigger NAFLD/NASH deterioration in a vicious cycle. NAFLD/NASH is also related to increased arterial stiffness (AS), an independent CVD risk factor that further raises CVD risk. Diagnosis of advanced liver fibrosis (mainly by simple non-invasive tests), CKD, and increased AS should be made early in the course of NAFLD and treated appropriately. Lifestyle measures and statin treatment may help resolve NAFLD/NASH and beneficially affect the CVD risk factors mentioned above.
authors.affiliation: Vasilios G Athyros, Niki Katsiki, Michael Doumas, Asterios Karagiannis, Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, 55132 Thessaloniki, Greece.
authors.forename: Vasilios G
authors.initials: VG
authors.lastname: Athyros
authors.affiliation: Vasilios G Athyros, Niki Katsiki, Michael Doumas, Asterios Karagiannis, Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, 55132 Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tziomalos
authors.affiliation: Vasilios G Athyros, Niki Katsiki, Michael Doumas, Asterios Karagiannis, Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, 55132 Thessaloniki, Greece.
authors.forename: Niki
authors.initials: N
authors.lastname: Katsiki
authors.affiliation: Vasilios G Athyros, Niki Katsiki, Michael Doumas, Asterios Karagiannis, Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, 55132 Thessaloniki, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Doumas
authors.affiliation: Vasilios G Athyros, Niki Katsiki, Michael Doumas, Asterios Karagiannis, Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, 55132 Thessaloniki, Greece.
authors.forename: Asterios
authors.initials: A
authors.lastname: Karagiannis
authors.affiliation: Vasilios G Athyros, Niki Katsiki, Michael Doumas, Asterios Karagiannis, Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, 55132 Thessaloniki, Greece.
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
mesh_terms: D001706:Biopsy; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D002423:Cause of Death; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008019:Life Style; D008103:Liver Cirrhosis / Q000453:epidemiology; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Arterial stiffness; Cardiovascular disease; Chronic kidney disease; Inflammation; Liver fibrosis; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Statins