Abstract
Nonalcoholic fatty liver disease (NAFLD) is considered a hepatic manifestation of metabolic syndrome, characterized from pathological changes in lipid and carbohydrate metabolism. Its main characteristics are excessive lipid accumulation and oxidative stress, which create a lipotoxic environment in hepatocytes leading to liver injury. Recently, many studies have focused on the identification of the genetic and epigenetic modifications that also contribute to NAFLD pathogenesis and their prognostic implications. The present review is aimed to discuss on cellular and metabolic alterations associated with NAFLD, which can be helpful to identify new noninvasive biomarkers. The identification of accumulated lipids in the cell membranes, as well as circulating cytokeratins and exosomes, provides new insights in understanding of NAFLD. This review also suggests that lifestyle modifications remain the main prevention and/or treatment for NAFLD.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is considered the most common form of chronic liver disease worldwide [1,2]
The liver damage in patients with NAFLD is accompanied by cell death that occurs primarily by apoptosis [75], which might be one of the drivers involved in the progression of NAFLD ranging from simple hepatic steatosis to non-alcoholic steatohepatitis (NASH), with and without fibrosis, and to cirrhosis or hepatocarcinoma
This study demonstrated that CK18 fragment levels were higher in subjects with NAFLD respect to controls, but they were correlated to grade of fibrosis and inflammation stage
Summary
Nonalcoholic fatty liver disease (NAFLD) is considered the most common form of chronic liver disease worldwide [1,2] It has been closely associated with metabolic syndrome, and its incidence is growing rapidly [1,2,3,4]. Epigenetics refers to the reversible changes in gene expression caused by environmental stimuli [20] In response to these external factors, as lifestyle habits and nutritional factors, the epigenetic modulation refers to DNA methylation, histone modifications, and the regulation of specific noncoding RNAs. Many studies have investigated the role of noncoding RNAs in the pathogenesis of NAFLD and their potential as biomarkers of the disease [21,22]. Alternative therapeutic approaches for NAFLD, based on dietary and lifestyle modification, are encouraged
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