Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus
Open accessAbstract
Nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus are common diseases that often coexist and might act synergistically to increase the risk of hepatic and extra-hepatic clinical outcomes. NAFLD affects up to 70-80% of patients with type 2 diabetes mellitus and up to 30-40% of adults with type 1 diabetes mellitus. The coexistence of NAFLD and diabetes mellitus increases the risk of developing not only the more severe forms of NAFLD but also chronic vascular complications of diabetes mellitus. Indeed, substantial evidence links NAFLD with an increased risk of developing cardiovascular disease and other cardiac and arrhythmic complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus. NAFLD is also associated with an increased risk of developing microvascular diabetic complications, especially chronic kidney disease. This Review focuses on the strong association between NAFLD and the risk of chronic vascular complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus, thereby promoting an increased awareness of the extra-hepatic implications of this increasingly prevalent and burdensome liver disease. We also discuss the putative underlying mechanisms by which NAFLD contributes to vascular diseases, as well as the emerging role of changes in the gut microbiota (dysbiosis) in the pathogenesis of NAFLD and associated vascular diseases.
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Few randomized statin trials have shown independently significant cardiovascular benefits in women, largely because women were underrepresented in those trials.
“Few randomized trials of statin therapy have reported independently significant CV benefits in women [387,389], chiefly because women have not been adequately represented in statin trials.”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [387]
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References 193 · Cited by 397
Research works printed but not linked: 2
- Nascimbeni, F. et al. Clinical relevance of liver histopathology and different histologic classifications of NASH in adults. Expert Review Gastroenterol. Hepatol. in press.
- B.M.J. Open Gastroenterol. 3, e000075 (2016). 184.
- Authors
- Targher, G., Lonardo, A., & Byrne, C. D.
- Affiliations
- Azienda Ospedaliera Universitaria Integrata Verona (IT)
- Azienda Ospedaliero-Universitaria di Modena (IT)
- Southampton General Hospital (GB)
- Corresponding author
- Targher, Giovanni
- Venue
- Nature Reviews Endocrinology
- Published
- 2017-12-29
- Volume
- 14
- Issue
- 2
- Pages
- 99-114
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- OpenAlex
- W2780780868
- Cited by
- 397
- References
- 193
- Citations by year
- 2026: 9 · 2025: 33 · 2024: 66 · 2023: 52 · 2022: 55 · 2021: 54 · 2020: 68 · 2019: 26 · 2018: 32
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.soton.ac.uk
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- National Institute for Health and Care Research
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- non-alcoholic fatty liver disease, diabetes mellitus, type 1 diabetes, type 2 diabetes, cardiovascular disease, cardiac arrhythmias, chronic kidney disease, microvascular complications, gut microbiota, dysbiosis, pathophysiological mechanisms, NAFLD treatment
- MeSH terms
- Chronic Disease, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Humans, Risk Factors, Vascular Diseases, Global Health, Incidence, Non-alcoholic Fatty Liver Disease
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