Cardiovascular comorbidity in non-alcoholic fatty liver disease

Abstract

The actual problem of modern medicine is the search for links between non-alcoholic fatty liver disease and cardiovascular diseases. The real clinical practice needs to deepen knowledge about the mutual infl uence of these two diseases and develop algorithms to accompany these patients. A review of current literature shows data on increasing cardiovascular risks and accelerating progression of liver pathology in the combination of non-alcoholic fatty liver disease and cardiovascular disease. The article describes the links of pathogenesis of non-alcoholic fatty liver disease aff ecting the development of cardiovascular diseases (insulin resistance, hypoadiponectinemia, hyperleptinemia, lipid metabolism disorders, activation of infl ammation, etc.). The role of infl ammation, hormonal changes and the infl uence of intestinal microbiota on the course of both diseases has been demonstrated. The review presents data on the infl uence of common risk factors (lipid metabolism disorder, carbohydrate metabolism disorder, obesity, etc.) on the course of both pathologies. The review presents the literature data on the connection of non-alcoholic fatty liver disease with the development of arterial hypertension (primarily due to an increase in vascular wall stiff ness), coronary heart disease (primarily due to endothelial dysfunction and hyperlipidemia), heart rhythm disorders, heart failure, cerebrovascular diseases. It has been shown that the connection between non-alcoholic fatty liver disease and cardiovascular diseases is bilateral and cardiovascular diseases can aggravate the course of liver diseases. The importance of further study of this issue is due to the mutual infl uence of non-alcoholic fatty liver disease and cardiovascular disease not only on the prognosis, but also on the tactics of patient management.