The phenomenon of metabolically associated fatty liver disease in the pathogenesis of cholelithiasis and hypertension

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a rapidly progressive disease in terms of prevalence. It is most common in male individuals, with an average age of onset around 50 years of age. People suffering from overweight, obesity, type 2 diabetes mellitus are particularly susceptible to the development of NAFLD due to common pathophysiological processes of development. Genetic and epigenetic factors determine the occurrence and progression of NAFLD. Among genes there are those that predominantly affect the development of NAFLD: PNPLA3, TM6SF2, GCKR, MBOAT7, HSD17B13. There are also ongoing studies on the following genes: APOB, PCSK9, APOC3, MTP, SOD2, TNF-a, TGF-b. Among the factors associated with the development of NAFLD, special attention is paid to insulin resistance and obesity, mitochondrial dysfunction, lipotoxicity and release of pro-inflammatory cytokines. The common mechanisms of development of NAFLD, hypertension (HT) and cholelithiasis (CHD) explain their frequent concurrent course. The modern presentation of pathogenesis excludes the possibility of further use of the diagnosis «nonalcoholic fatty liver disease», as it has become clear that liver damage is multifactorial and cannot be defined as a «diagnosis of exclusion». The need to optimise the term NAFLD into «metabolically associated fatty liver disease» is being actively discussed.