Key result
Visceral adiposity and metabolic syndrome are linked to NASH development and worse HCV progression.
Why the study?
The increasing prevalence of lifestyle-related diseases such as insulin resistance and visceral fat obesity in Japan has raised concerns about their role in progressive liver diseases including NAFLD and NASH, necessitating a review of recent research on fat accumulation-related liver disease and metabolic syndrome.
This review highlights the role of visceral fat obesity and metabolic syndrome in the progression of non-alcoholic steatohepatitis and HCV-related liver disease.
Should not yet change management of NASH or HCV; leaves open whether targeting visceral fat improves outcomes.
Although steatohepatitis can be induced by an excessive intake of alcohol, it can also arise through various other causes, in which case it is known as non-alcoholic fatty liver disease (NAFLD). NAFLD is classified into two categories:simple fatty liver with a favorable clinical outcome, and non-alcoholic steatohepatitis (NASH), which is intractable and progressive. Recently in Japan, there has been an increase in the number of individuals at risk of lifestyle-related diseases, due to increased insulin resistance and visceral fat obesity. The metabolic syndrome (MS) is associated with several risk factors for atherosclerosis, including diabetes mellitus (DM), hypertension, and hyperlipidemia. Visceral fat obesity is the prime cause of NASH in the liver, and is therefore considered to be one of the phenotypic features of MS. Furthermore, most chronic liver diseases are associated with hepatitis C virus (HCV) infection. Fatty degeneration of hepatocytes is often observed in the liver of HCV-infected individuals, and results from viral suppression of mitochondrial beta-oxidation of fatty acid. The natural outcome of HCV infection is worse in patients with lifestyle-related high insulin resistance and visceral fat obesity. In this review, we describe the recent advances in research on progressive liver diseases that are the result of fat accumulation in the liver, with special reference to MS.
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Saito et al. (2007) conducted a review in Non-alcoholic steatohepatitis (NASH) and Metabolic Syndrome. Metabolic syndrome and visceral fat obesity was evaluated. Visceral fat obesity and metabolic syndrome are closely associated with the pathogenesis of non-alcoholic steatohepatitis and worsen the natural course of hepatitis C virus infection.
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