Nonalcoholic liver disease: review with a focus on risks of progression

Nonalcoholic fatty liver disease (NAFLD) is a disease which etiology is related to various metabolic, ethnic, genetic and even ecologic factors. Complexity of etiology and multiply pathogenesis ways, leading eventually to the lipid droplets appearance in hepatocytes, infl ammation process and parenchyma fi brosis in liver, and also frequent cardiometabolic comorbidities, together make diffi cult risks stratifi cation and prognosis evaluation in NAFLD patients. Another matter is a question of NAFLD therapy, since unifi ed pharmacotherapy approaches are not yet adopted worldwide, and lifestyle modifi cation being accepted as an eff ective therapeutic approach, is not followed by patients in real world setting. Current review is dedicated to the consideration of NAFLD diagnostics, its risk of progression and existing therapeutical capabilities.

Triglyceride and Glucose Index as a Screening Tool for Nonalcoholic Liver Disease in Patients with Metabolic Syndrome

Background: Nonalcoholic fatty liver disease (NAFLD) is regarded as a component of metabolic syndrome, which has insulin resistance (IR) as the primary physiopathological event. The aim of study was to establish the association between IR, assessed using triglyceride and glucose index (TyG), and histopathological features of NAFLD lesions. Methods: The study included patients with metabolic syndrome. Fasting plasma glucose (FPG), fasting lipid profiles and liver enzymes were measured. IR was assessed by TyG index. Liver biopsy was performed for assessment steatosis and fibrosis. Results: TyG index had a mean value of 8.93 ± 1.45, with a higher value in the patients with overweight (p=0.002) and obesity (p=0.004) than in the patients with normal weight. TyG index mean value of 8.78 ± 0.65 in subjects without NASH, 8.91 ± 0.57 in patients with borderline NASH and 9.13 ± 0.55 in patients with definite NASH. Significant difference was found between subjects without NASH and the ones with definite NASH (p=0.004). The analysis of the area under the ROC curve proved that TyG index is a predictor for NASH (p=0.043). Conclusion: TyG index is a facile tool used to identify individuals at risk for NAFLD, but not for the progression of liver lesions.

Triglyceride and Glucose Index as a Screening Tool for Nonalcoholic Liver Disease in Patients with Metabolic Syndrome

Background: Nonalcoholic fatty liver disease (NAFLD) is regarded as a component of metabolic syndrome, which has insulin resistance (IR) as the primary physiopathological event. The aim of study was to establish the association between IR, assessed using triglyceride and glucose index (TyG), and histopathological features of NAFLD lesions. Methods: The study included patients with metabolic syndrome. Fasting plasma glucose (FPG), fasting lipid profiles and liver enzymes were measured. IR was assessed by TyG index. Liver biopsy was performed for assessment steatosis and fibrosis. Results: TyG index had a mean value of 8.93 ± 1.45, with a higher value in the patients with overweight (p=0.002) and obesity (p=0.004) than in the patients with normal weight. TyG index mean value of 8.78 ± 0.65 in subjects without NASH, 8.91 ± 0.57 in patients with borderline NASH and 9.13 ± 0.55 in patients with definite NASH. Significant difference was found between subjects without NASH and the ones with definite NASH (p=0.004). The analysis of the area under the ROC curve proved that TyG index is a predictor for NASH (p=0.043). Conclusion: TyG index is a facile tool used to identify individuals at risk for NAFLD, but not for the progression of liver lesions.

Effects of betaine on Nonalcoholic liver disease

Nonalcoholic fatty liver disease (NAFLD) is increasingly prevalent, and the challenge of prevention and treatment is increasing. The “multiple hits” hypothesis of multiple insults, such as dietary fat intake, de novo lipogenesis, insulin resistance, oxidative stress, mitochondrial dysfunction, gut dysbiosis and hepatic inflammation, can provide a more accurate explanation of the pathogenesis of NAFLD. Betaine plays important roles in regulating the genes associated with NAFLD through anti-inflammatory effects, increased free fatty oxidation, anti-lipogenic effects, and improved insulin resistance and mitochondrial function; however, the mechanism of betaine remains elusive.

Editorial “Nutrition and Dietary Intake for Liver-Related Diseases”

In this special issue, we focus on the role of nutrition in the therapy of nonalcoholic liver disease (NAFLD) [...]