Abstract
Non-alcoholic fatty liver disease (NAFLD), which is emerging as a major public health issue worldwide, is characterized by a wide spectrum of liver disorders, ranging from simple fat accumulation in hepatocytes, also known as steatosis, to non-alcoholic steatohepatitis (NASH) and cirrhosis. At present, the pharmacological treatment of NAFLD is still debated and dietary strategies for the prevention and the treatment of this condition are strongly considered. Polyphenols are a group of plant-derived compounds whose anti-inflammatory and antioxidant properties are associated with a low prevalence of metabolic diseases, including obesity, hypertension, and insulin resistance. Since inflammation and oxidative stress are the main risk factors involved in the pathogenesis of NAFLD, recent studies suggest that the consumption of polyphenol-rich diets is involved in the prevention and treatment of NAFLD. However, few clinical trials are available on human subjects with NAFLD. Here, we reviewed the emerging existing evidence on the potential use of polyphenols to treat NAFLD. After introducing the physiopathology of NAFLD, we focused on the most investigated phenolic compounds in the setting of NAFLD and described their potential benefits, starting from basic science studies to animal models and human trials.
Highlights
Non-Alcoholic Fatty Liver Disease (NAFLD) is a clinical condition primarily characterized by fat accumulation in liver parenchyma (>5% of hepatocytes)
Its definition accounts for a condition in which fat in liver parenchyma is above the normal quantity and shows the same histopathological features of alcohol-induced liver steatosis, but it is recognized in patients who drink little to no alcohol [3]
The international threshold observed by international guidelines to distinguish the alcohol-induced fatty liver disease from Non-alcoholic fatty liver disease (NAFLD) is represented by two drinks, corresponding to 20 g of alcohol intake per day [4]
Summary
Non-Alcoholic Fatty Liver Disease (NAFLD) is a clinical condition primarily characterized by fat accumulation in liver parenchyma (>5% of hepatocytes). Fatty Liver—SFL) to steatohepatitis (Non-Alcoholic Steatohepatitis—NASH), ending with hepatic cirrhosis and hepatocarcinoma, through a progressive fibrosis of the organ [1]. These advanced stages are associated with higher mortality, but all stages of NAFLD can significantly increase the risk of cardiovascular diseases, since these are the most prevalent clinical features in NAFLD [2]. Its definition accounts for a condition in which fat in liver parenchyma is above the normal quantity and shows the same histopathological features of alcohol-induced liver steatosis, but it is recognized in patients who drink little to no alcohol [3]. The histopathological hallmark of NAFLD is steatosis, the common central feature, which is the accumulation of lipid droplets in hepatocytes; signs of cell damage, such as ballooning and apoptotic changes and Mallory-Denk bodies are typical, while the portal and lobular inflammatory infiltrate is more specific tothe NASH stage [3].
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