Metabolic syndrome, non-alcoholic fatty liver disease and hepatocarcinoma.
Mario Serradilla MartínJosé Ramón Oliver GuillénAna Palomares CanoJose Manuel RamiaPublished in: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva (2021)
The term "metabolic syndrome" refers to a group of alterations comprising central obesity reduced high-density lipoprotein cholesterol concentrations, elevated triglyceride concentrations, arterial hypertension, and hyperglycemia. This syndrome has established itself as one of the epidemics of the 21st century. Among its causative agents are insulin resistance, leptin and adiponectin, changes in microbiota, and epigenetics. Its incidence in the European population is estimated to be around 25%. Non-alcoholic fatty liver disease is the hepatic manifestation of metabolic syndrome; its prevalence parallels that of obesity, and it has increased exponentially in recent decades. Recently, several publications have linked metabolic risk factors with the onset and development of hepatocarcinoma, and so it is essential to determine whether patients with non-alcoholic fatty liver disease should follow a protocol for hepatocarcinoma screening. At present, the worldwide incidence of hepatocarcinoma in patients with non-alcoholic fatty liver disease without cirrhosis is only 2.7%. Screening for hepatocarcinoma in patients with non-alcoholic fatty liver disease and cirrhosis is mandatory, but the low incidence of hepatocarcinoma in patients without cirrhosis does not justify the systematic monitoring of this patient population. Current efforts are based on identifying subgroups of patients with non-alcoholic fatty liver disease and a higher-than-average risk of developing hepatocarcinoma.
Keyphrases
- metabolic syndrome
- insulin resistance
- risk factors
- liver fibrosis
- high fat diet
- uric acid
- adipose tissue
- high fat diet induced
- polycystic ovary syndrome
- cardiovascular risk factors
- type diabetes
- skeletal muscle
- newly diagnosed
- randomized controlled trial
- case report
- ejection fraction
- quality improvement
- body mass index
- preterm infants
- physical activity