A Multidisciplinary Approach and Current Perspective of Nonalcoholic Fatty Liver Disease: A Systematic Review.
| Autor: | Zaman CF; Medicine and Surgery, Jahurul Islam Medical College and Hospital, Kishoreganj, BGD., Sultana J; Medicine, Comilla Medical College, Cumilla, BGD., Dey P; Internal Medicine, Chittagong Medical College, Chattogram, BGD., Dutta J; Medicine, Comilla Medical College, Cumilla, BGD., Mustarin S; Medicine, Mymensingh Medical College, Mymensingh, BGD., Tamanna N; Medicine, Rangpur Medical College and Hospital, Rangpur, BGD., Roy A; Medicine, Sher-e-Bangla Medical College, Barisal, BGD., Bhowmick N; Medicine, Shaheed Ziaur Rahman Medical College, Bogra, BGD., Khanam M; Internal Medicine, Dhaka Medical College, Dhaka, BGD., Sultana S; Medicine, Anwer Khan Modern Medical College, Dhaka, BGD., Chowdhury S; Internal Medicine, Dhaka Medical College, Dhaka, BGD., Khanam F; Medicine, Central Medical College, Cumilla, BGD., Sakibuzzaman M; Neurology, The University of Toledo, Toledo, USA.; Internal Medicine, University of Mississippi Medical Center, Jackson, USA.; Internal Medicine, Sir Salimullah Medical College, Dhaka, BGD.; Experimental Pathology (Cancer Biology), Mayo Clinic, Rochester, USA., Dutta P; Internal Medicine, Trinity Health, St. Joseph Mercy Ann Arbor, Ann Arbor, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2022 Sep 27; Vol. 14 (9), pp. e29657. Date of Electronic Publication: 2022 Sep 27 (Print Publication: 2022). |
| DOI: | 10.7759/cureus.29657 |
| Abstrakt: | In recent times, nonalcoholic fatty liver disease (NAFLD) has been considered one of the major causes of liver disease across the world. NAFLD is defined as the deposition of triglycerides in the liver and is associated with obesity and metabolic syndrome. Hyperinsulinemia, insulin resistance (IR), fatty liver, hepatocyte injury, unbalanced proinflammatory cytokines, mitochondrial dysfunction, oxidative stress, liver inflammation, and fibrosis are the main pathogenesis in NAFLD. Recent studies suggest that the action of intestinal microbiota through chronic inflammation, increased intestinal permeability, and energy uptake plays a vital role in NAFLD. Moreover, polycystic ovarian syndrome also causes NAFLD development through IR. Age, gender, race, ethnicity, sleep, diet, sedentary lifestyle, and genetic and epigenetic pathways are some contributing factors of NAFLD that can exacerbate the risk of liver cirrhosis and hepatocellular carcinoma (HCC) and eventually lead to death. NAFLD has various presentations, including fatigue, unexplained weight loss, bloating, upper abdominal pain, decreased appetite, headache, anxiety, poor sleep, increased thirst, palpitation, and a feeling of warmth. Some studies have shown that NAFLD with severe coronavirus disease 2019 (COVID-19) has poor outcomes. The gold standard for NAFLD diagnosis is liver biopsy. Other diagnostic tools are imaging tests, serum biomarkers, microbiota markers, and tests for extrahepatic complications. There are no specific treatments for NAFLD. Therefore, the main concern for NAFLD is treating the comorbid conditions such as anti-diabetic agents for type 2 diabetes mellitus, statins to reduce HCC progression, antioxidants to prevent hepatocellular damage, and bariatric surgery for patients with a BMI of >40 kg/m 2 and >35 kg/m 2 with comorbidities. Lifestyle and dietary changes are considered preventive strategies against NAFLD advancement. Inadequate treatment of NAFLD further leads to cardiac consequences, sleep apnea, chronic kidney disease, and inflammatory bowel disease. In this systematic review, we have briefly discussed the risk factors, pathogenesis, clinical features, and numerous consequences of NAFLD. We have also reviewed various guidelines for NAFLD diagnosis along with existing therapeutic strategies for the management and prevention of the disease. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Zaman et al.) |
| Databáze: | MEDLINE |
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