title: A "systems medicine" approach to the study of non-alcoholic fatty liver disease.
abstract: The prevalence of fatty liver (steatosis) in the general population is rapidly increasing worldwide. The progress of knowledge in the physiopathology of fatty liver is based on the systems biology approach to studying the complex interactions among different physiological systems. Similarly, translational and clinical research should address the complex interplay between these systems impacting on fatty liver. The clinical needs drive the applications of systems medicine to re-define clinical phenotypes, assessing the multiple nature of disease susceptibility and progression (e.g. the definition of risk, prognosis, diagnosis criteria, and new endpoints of clinical trials). Based on this premise and in light of recent findings, the complex mechanisms involved in the pathology of fatty liver and their impact on the short- and long-term clinical outcomes of cardiovascular, metabolic liver diseases associated with steatosis are presented in this review using a new "systems medicine" approach. A new data set is proposed for studying the impairments of different physiological systems that have an impact on fatty liver in different subsets of subjects and patients.
authors.affiliation: Section of Gastroenterology, Di.Bi.M.I.S Policlinico Paolo Giaccone Hospital, University of Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Petta
authors.affiliation: Internal Medicine, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, University of Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Valenti
authors.affiliation: Gastroenterology and Hepatology, Department of Medical Sciences, Città della Salute e della Scienza di Torino Hospital, University of Turin, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bugianesi
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University Hospital of Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
authors.affiliation: Shrewsbury and Telford NHS Trust, Department of Gastroenterology, Shrewsbury, UK; Fondazione Italiana Fegato, Bassovizza, Trieste, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bellentani
authors.affiliation: General Medicine 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Italy. Electronic address: ferruccio.bonino@unipi.it.
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Bonino
mesh_terms: D018450:Disease Progression; D006801:Humans; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy; D010641:Phenotype; D012307:Risk Factors; D013597:Systems Analysis; D049490:Systems Biology
keywords: Fatty liver; Medicine; NAFLD; NASH; Personalized; Systems medicine