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Review article: non-alcoholic fatty liver disease and cardiovascular diseases: associations and treatment considerations

Polyzos, SA; Kechagias, S; Tsochatzis, EA; (2021) Review article: non-alcoholic fatty liver disease and cardiovascular diseases: associations and treatment considerations. Alimentary Pharmacology and Therapeutics , 54 (8) pp. 1013-1025. 10.1111/apt.16575. Green open access

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Abstract

Background: There are increasing data on the association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD). // Aim: To summarise evidence on the association between NAFLD and CVD in the clinical setting and provide potential therapeutic implications. // Methods: We searched PubMed. Evidence was primarily derived from meta-analyses. and then, if data were insufficient, from clinical trials, and then from observational studies. // Results: NAFLD has been linked to arterial hypertension, arterial stiffness, atherosclerosis, coronary artery disease, atrial fibrillation and aortic valvular sclerosis. Advanced liver fibrosis is a crucial prognostic factor for end-stage liver disease and for cardiovascular and overall mortality. Weight loss through lifestyle modifications (diet and exercise) remains the cornerstone of the management of both NAFLD and CVD, but is difficult to achieve and possibly more difficult to sustain long term. Therefore, pharmacological management of NAFLD seems to be important, although no licenced medication currently exists. Pioglitazone, proposed for non-alcoholic steatohepatitis (NASH) by most guidelines, increases weight and should be avoided in congestive heart failure. Statins should not be avoided in NAFLD patients at risk for CVD. Glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter-2 inhibitors, two classes of anti-diabetic drugs, have shown promising results in NAFLD and CVD, but more studies with hard end points are needed. Obeticholic acid, a promising medication for NASH under investigation, should be carefully considered, owing to its adverse effect on lipid profile. // Conclusions: NAFLD is associated with CVD, which may have certain clinical and therapeutic implications.

Type: Article
Title: Review article: non-alcoholic fatty liver disease and cardiovascular diseases: associations and treatment considerations
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/apt.16575
Publisher version: https://doi.org/10.1111/apt.16575
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/10134641
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