Abstract

Non-alcoholic fatty liver disease (NAFLD) is characterized by excess lipids in hepatocytes, due to excessive fatty acid influx from adipose tissue, de novo hepatic lipogenesis, in addition to excessive dietary fat and carbohydrate intake. Chronic hepatic lipid overload induces mitochondrial oxidative stress and cellular damage leading the development of NAFLD into a more severe liver disease condition, non-alcoholic steato-hepatitis (NASH). In turn, this can progress to cirrhosis and hepatocellular carcinoma (HCC). Among others, copper is one of the main bio-metals required for the preponderance of the enzymes involved in physiological redox reactions, which primarily occurs during mitochondrial respiration. Thus, copper homeostasis could be considered a target point for counteracting the progression of NAFLD. Accordingly, many diseases are correlated to unbalanced copper levels and, actually, some clinical trials are examining the use of copper chelating agents. Currently, no pharmacological interventions are approved for NAFLD, but nutritional and lifestyle modifications are always recommended. Fittingly, antioxidant food agents recognized to improve NAFLD and its complications have been described in the literature to bind copper. Therefore, this review describes the role of nutrition in the development and progression of NAFLD with a particular focus on copper and copper-binding antioxidant compounds against NAFLD.

Highlights

  • Non-alcoholic fatty liver disease (NAFLD) consists of fat accumulation in the liver and affects about 1.8 billion people [1]

  • NAFLD can progress towards non-alcoholic steato-hepatitis (NASH), which is a more severe condition characterized by necro-inflammation with or without fibrosis

  • NAFLD is considered the hepatic manifestation of the metabolic syndrome, which is mainly characterized by obesity, dyslipidemia, insulin resistance, hypertension, and type 2 diabetes

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Summary

Introduction

Non-alcoholic fatty liver disease (NAFLD) consists of fat accumulation in the liver (hepatic steatosis) and affects about 1.8 billion people [1]. NAFLD can progress towards non-alcoholic steato-hepatitis (NASH), which is a more severe condition characterized by necro-inflammation with or without fibrosis. This can lead to cirrhosis and hepatocellular carcinoma (HCC). In asymptomatic morbidly obese patients, there is a very high prevalence of approximately 90% of NAFLD Of these morbidly obese patients with NAFLD, more than one-third fit the histological criteria for NASH [3,4]. Taken together, all these conditions have resulted in NAFLD being considered an important problem for the health burden nationwide. The aim of this review is to discuss the pathogenesis and worsening of NAFLD in relation to nutrition, with a special regard to copper and to copper-binding natural antioxidant compounds against NAFLD

Pathophysiology of NAFLD and Nutritional Implications
Dietary Fats
Dietary Carbohydrates
NAFLD-Related Oxidative Stress
Special Focus on Copper
Copper Homeostasis and Metabolism
Copper
Copper and Its Role in NAFLD Onset and Progression
Copper and Nutrients in NAFLD
Summary
Findings
Conclusions
Full Text
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