Weight loss breaks the bond between nonalcoholic fatty liver disease and cardiovascular diseases: A clinical and epidemiological perspective.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a growing health concern that is closely related to obesity and metabolic syndrome. In particular, NAFLD has been increasingly reported in adolescents and young adults in recent years. Cardiovascular diseases (CVDs) such as cardiac remodeling, heart failure, myocardial infarction, valvular heart diseases, and arrhythmia are more common in patients with NAFLD. CVD are the major cause of mortality in NAFLD. Although NAFLD often affects patients with obesity/overweight, it can also affect subjects with normal body mass index (BMI), known as lean NAFLD, which has a strong correlation with CVD. Obesity imposes a considerably increased risk of NAFLD and CVD. Consistently, weight-lowering approaches that can pronouncedly decrease body weight and maintain it in the long term, such as bariatric surgery and treatment with semaglutide and tirzepatide, have been promising in alleviating both CVD and NAFLD. Interestingly, compared with patients with NAFLD and obesity, a minimal amount of weight loss resolves NAFLD in lean patients. Besides the widespread use of bariatric surgery, the development of new GLP-1 agonists and GLP-1 GIP agonists revolutionized the treatment of obesity in recent years. Here, we discuss the interwoven correlation between obesity, NAFLD, and CVD and the benefits of weight-lowering approaches.