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Impact of Obesity in Non-Alcoholic Fatty Liver Disease

DOI: 10.4236/jbise.2021.142004, PP. 21-32

Keywords: Non-Alcoholic Fatty Liver Disease, Obesity, Diabetes, Cardiovascular Diseases, Insulin Resistance Metabolic Syndrome and Biopsy

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“Non-alcoholic fatty liver disease” is the alarming health risk around the world today. Nearly 1/3 of the world’s population is affected by non-alcoholic fatty liver disease. Many scientists put forward two hit hypotheses to explain the pathophysiology of non-alcoholic fatty liver disease. With the aid of trials using Biopsy, ultrasound scan and molecular techniques, scientists explained an authentic evidence of non-alcoholic fatty liver disease progression is ultimately because of obesity and its commodities, such as Cardio vascular diseases, Diabetes and Metabolic syndrome. This review mainly focuses on how obesity leads to non-alcoholic fatty liver disease based on statistical analysis of different research studies conducted by the research scientists. In the analysis of 1980-2003, out of 505 individuals, 305 were affected with NAFLD and among them, 64.3% were obese. In the analysis of the period of 1996-2002, out of 550 NAFLD patients, 70.36% were obese. Also in the analysis of 2010-2015 period of time, mostly 90% of the NAFLD patients were obese. It was also revealed that, along with NAFLD and obesity, diabetes and hyperlipidemia also exist as the commodities of obesity. Attention of medical field is towards the treatment and analysis of non-alcoholic fatty liver disease which is expected to be the reason of liver transplant by 2020.


[1]  Chan, W.K., Hilmi, N.D.A., Cheah, P.L. and Goh, K.L. (2014) Progression of Liver Disease in Non-Alcoholic Fatty Liver Disease: A Prospective Clinicopathological Follow-Up Study. Journal of Digestive Diseases, 15, 542-552.
[2]  Lomonaco, R., Ortiz-Lopez, C., Orsak, B., Webb, A., Hardies, J., Darland, C., Finch, J., Gastaldelli, A., Harrison, S., Tio, F. and Cusil, K. (2012) Effect of Adipose Tissue Insulin Resistance on Metabolic Parameters and Liver Histology in Obese Patients with Nonalcoholic Fatty Liver Disease. Hepatology, 55, 5-7.
[3]  Mc Collough, A.J. and George, B.G. (2016) Natural History of Nonalcoholic Fatty Liver Disease, Hepatology, 2, 54-58.
[4]  Ludwig, J., Viggiano, T.R., McGill, D.B. and Oh, B.J. (1980) Nonalcoholic Steatohepatitis: Mayo Clinic Experiences with a Hitherto Unnamed Disease. Journal of Gastroenterology and Hepatology, 55, 434-438.
[5]  Maheshwari, A. and Thuluvath, P.J. (2011) Endocrine Disease and the Liver. Clinics in Liver Disease, 15, 55-67.
[6]  Adams, L.A., Zein, C.O., Angulo, P. and Lindor, K.D. (2004) A Pilot Trial of Pentoxifylline in Nonalcoholic Steatohepatitis. American Journal Gastroenterology, 99, 2365-2368.
[7]  Rafiq, N., Bai, C., Fang, Y., Srishord, M., McCullough, A., Gramlich, T. and Younossi, Z.M. (2009) Long-Term Follow-Up of Patients with Nonalcoholic Fatty Liver. Clinical Gastroenterology, 7, 234-238.
[8]  Dunn, W., Xu, R., Wingard, D.L., Rogers, C., Angulo, P., Younossi, Z.M. and Schwimmer, J.B. (2008) Suspected Nonalcoholic Fatty Liver Disease and Mortality Risk in a Population-Based Cohort Study. American Journal of Gastroenterology, 103, 2263-2271.
[9]  Bhala, N., Angulo, P., Vander, P.D., Lee, E., Hui, J.M., Saracco, G., Adams, L.A., Charatcharoenwitthaya, P., Topping, J.H., Bugianesi, E., Day, C.P. and George, J. (2011) The Natural History of Nonalcoholic Fatty Liver Disease with Advanced Fibrosis or Cirrhosis: An International Collaborative Study. Hepatology, 54, 1208-1216.
[10]  Baffy, G., Brunt, E.M. and Caldwell, S.H. (2012) Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease: An Emerging Menace. Journal of Hepatology, 56, 1384-1391.
[11]  Pais, R., Charlotte, F., Fedchuk, L., Bedossa, P., Lebray, P., Poynard, T. and Ratziu, V. (2013) A Systematic Review of Follow-Up Biopsies Reveals Disease Progression in Patients with Non-Alcoholic Fatty Liver. Journal of Hepatology, 59, 550-556.
[12]  Powell, E.E., Cooksley, W.G., Hanson, R., Searle, J., Halliday, J.W. and Powell, L.W. (1990) The Natural History of Nonalcoholic Steatohepatitis: A Follow-Up Study of Forty-Two Patients for Up to 21 Years. Hepatology, 11, 74-80.
[13]  Younossi, Z.M., Otgonsuren, M., Henry, L., Venkatesan, C., Mishra, A., Erario, M. and Hunt, S. (2015) Association of Non-Alcoholic Fatty Liver Disease (NAFLD) with Hepatocellular Carcinoma (HCC) in Unites States from 2004 to 2009. Hepatology, 62, 1723-1730.
[14]  Yilmaz, Y. (2012) Is Nonalcoholic Fatty Liver Disease the Hepatic Expression of the Metabolic Syndrome. World Journal of Hepatology, 4, 332-334.
[15]  Lazo, M., Ruben, H. and Clark, J.M. (2013) Prevalence of Non Alchoholic Fatty Liver Diseases in Unites States: The Third National Health and Nutrition Examination Survey, 1988-1994. American Journal of Epidemiology, 178, 38-45.
[16]  Cortez-Pinto, H., Camilo, M.E., Baptista, A., DeOliveira, A.G. and Moura, M.C. (1999) Nonalcoholic Fatty Liver Disease: Another Feature of the Metabolic Syndrome. Clinical Nutrition, 18, 353-358.
[17]  Loomba, R. and Sanyal, A.J. (2013) The Global NAFLD Epidemic. Hepatology, 10, 686-690.
[18]  Sarah, J.W., Gong, I., Kim, R., Levstik, M., Beaton, M. and Tirona, R. (2013) Regulation of Cytochrome P4503A4 in Nonalcoholic Fatty Liver Disease by Fibroblast Growth Factor. Hepatology, 27, 537-548.
[19]  Weston, S.R., Leyden, W., Murphy, R., Bass, N.M., Bell, B.P., Manos, M.M. and Terrault, N.A. (2005) Racial and Ethnic Distribution of Nonalcoholic Fatty Liver in Persons with Newly Diagnosed Chronic Liver Disease. Hepatology, 41, 372-379.
[20]  Charlton, M.R., Burns, J.M., Pederson, R.A., Watt, K.D., Heimbach, J.K. and Dierkhising, R.A. (2011) Frequency and Outcomes of Liver Transplantation for Nonalcoholic Steatohepatitis in the United States. Gastroenterology, 141, 1249-1253.
[21]  Rinella, M. and Charlton, M. (2016) The Globalization of Nonalcoholic Fatty Liver Disease: Prevalence and Impact on World Health. Hepatology, 64, 19-22.
[22]  Wong, V.W., Vergniol, J., Wong, G.L., Foucher, J., Chan, H.L., Le Bail, B., Choi, P.C., Kowo, M., Chan, A.W. and Merrouche, W. (2010) Diagnosis of Fibrosis and Cirrhosis Using Liver Stiffness Measurement in Nonalcoholic Fatty Liver Disease. Hepatology, 51, 454-462.
[23]  Patton, H.M., Yates, K., Unalp-Arida, A., Behling, C.A., Huang, T.T.K., Rosenthal, P., Sanyal, A.J., Schimmer, J.B. and Lavine, J.E. (2010) Association between Metabolic Syndrome and Liver Histology among Children with Nonalcoholic Fatty Liver Disease. American Journal of Gastroenterology, 105, 2093-2102.
[24]  Croke, B. and Sampson, D. (2012) Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and Health Promotion. The Journal of Nurse Practitioners, 8, 45-50.
[25]  Pacifico, L., Cantisani, V., Ricci, P., John, F., Osborn, Schiavo, E., Anania, C., Ferrara, E., Dvisic, G. and Chiesa, D. (2008) Nonalcoholic Fatty Liver Disease and Carotid Atherosclerosis in Children. International Pediatric Research Foundation, 63, 423-427.
[26]  Maheshwari, A. and Thuluvath, P.J. (2006) Cryptogenic Cirrhosis and NAFLD. American Journal of Gastroenterology, 101, 665-668.
[27]  Mencin, A.A. and Lavine, J.E. (2011) Advances in Pediatric Nonalcoholic Fatty Liver Disease. American Journal of Gastroenterology, 58, 1375-1392.
[28]  Amirkalali, B., Poustchi, H., Keyvani, H., Khansari, M.R., Ajaarkosh, H., Maadi, M., Shorabi, M.R. and Zamani, F. (2014) Prevalence of Nonalcoholic Fatty Liver Disease and Its Predictors in North of Iran. Iran Journal of Public Health, 43, 1275-1253.
[29]  Younossi, Z.M., Koenig, A.B., Abdelatif, D., Fazel, Y., Henry, C. and Wymer, M. (2016) Global Epidemiology of Nonalcoholic Fatty Liver Disease-Meta-Analytic Assessment of Prevalence, Incidence, and Outcomes. Hepatology, 64, 73-84.
[30]  Lu, J., Zhang, J., Du, R., Wang, T., Xu, M., Xu, Y., Wang, W., Bi, Y., Li, D., Chen, Y. and Ning, G. (2016) Age at Menarche Is Associated with the Prevalence of Nonalcoholic Fatty Liver Disease Later in Life. Journal of Diabetes, 9, 53-60.
[31]  Singh, S., Singh, P.P., Singh, A.G., Murad, M.H. and Sanchez, W. (2013) Statins Are Associated with a Reduced Risk of Hepatocellular Cancer: A Systemic Review and Meta-Analysis. Gastroenterology, 144, 323-332.
[32]  Dowman, J.K., Tomlinson, J.W. and Newsome, P.N. (2010) Pathogenesis of Nonalcoholic Fatty Liver Disease. Hepatology, 103, 71-83.
[33]  Chiang, D.J., Pritchard, M.T. and Nagy, L.E. (2011) Obesity, Diabetes Mellitus and Liver Fibrosis. American Journal of Gastroenterology, 30, 697-702.
[34]  Jarvinen, Y.H. (2016) Diagnosis of Nonalcoholic Fatty Liver Disease (NAFLD). Diabetologia, 59, 1104-1110.
[35]  Lee, R.G. (1989) Nonalcoholic Steatohepatitis: A Study of 49 Patients. Human Pathology, 20, 594-598.
[36]  Willner, I.R., Waters, B., Patil, S.R., Reuben, A., Morelli, J. and Riely, C.A. (2001) Ninety Patients with Nonalcoholic Steatohepatitis: Insulin Resistance, Familial Tendency, and Severity of Disease. American Journal of Gastroenterology, 96, 2957-2961.
[37]  Marchesini, G., Brizi, M., Bianchi, G., Tomassetti, S., Bugianesi, E., Lenzi, M., McCollough, A.J., Natale, S., Forlani, G. and Melchionda, N. (2001) Nonalcoholic Fatty Liver Disease: A Feature of the Metabolic Syndrome. Diabetes, 50, 1844-1850.
[38]  Blackett, P.R. and Sanghera, D.K. (2016) Genetic Determinants of Cardiometabolic Risk: A Proposed Model for Phenotype Association and Interaction. Journal of Clinical Lipidology, 7, 65-81.
[39]  Adamo, E., Northurp, V., Weiss, R., Santro, N., Pierpont, B., Savoye, M., O’Malley, G. and Caprio, S. (2010) Ethnic Differences in Lipoprotein Subclasses in Obese Adolescents: Importance of Liver and Intraabdominal Fat Accretion. American Journal of Clinical Nutrition, 92, 500-508.
[40]  Solderberg, C., Stal, P., Askling, J., Glaumann, H., Lindaberg, G., Murmur, J. and Hulterantz, R. (2010) Decreased Survival of Elevated Liver Function Test during 28 Year Follow Up. Hepatology, 51, 595-602.
[41]  Sert, A., Pirgon, O., Aypar, E., Yilmaz, H. and Odabas, D. (2012) Relationship between Left Ventricular Mass and Carotid Intima Media Thickness in Obese Adolescents with Non-Alcoholic Fatty Liver Disease. Journal of Pediatric Endocrinology and Metabolism, 25, 927-934.
[42]  Ekstedt, M., Hagstrom, H., Nasr, P., Fredrikson, M., Stal, P., Kechagias, S. and Hultcrantz, R. (2015) Fibrosis Stage Is the Strongest Predictor for Disease-Specific Mortality in NAFLD after Up to 33 Years of Follow-Up. Hepatology, 61, 1547-1554.
[43]  Laurin, J.I., Lindor, K.D., Crippin, J.S., Gossard, A., Gores, G.J., Ludwig, J., Rakela, J. and McGill, D.B. (1996) Ursodeoxycholic Acid or Clofibrate in the Treatment of Non-Alcohol-Induced Steatohepatitis: A Pilot Study. Hepatology, 23, 1464-1467.
[44]  Matteoni, C.A., Younossi, Z.M., Gramlich, T., Boparai, N., Liu, Y.C. and McCullough, A.J. (1999) Nonalcoholic Fatty Liver Disease: A Spectrum of Clinical and Pathological Severity. Gastroenterology, 116, 1413-1419.
[45]  Angulo, P., Keach, J.C., Batts, K.P. and Lindor, K.D. (1999) Independent Predictors of Liver Fibrosis in Patients with Nonalcoholic Steatohepatitis. Hepatology, 30, 1356-1362.
[46]  Chitturi, S., Abeygunasekera, S., Farrell, G.C., Holmes-Walker, J., Hui, J.M., Fung, C., Karim, R., Lin, R., Samarasinghe, D., Liddle, C. and Weltman, M. (2002) NASH and Insulin Resistance: Insulin Hypersecretion and Specific Association with the Insulin Resistance Syndrome. Hepatology, 35, 373-379.
[47]  Evans, C., Oien, K., MacSween, R. and Mills, P. (2002) Non-Alcoholic Steatohepatitis: A Common Cause of Progressive Chronic Liver Injury? Journal of Clinical Pathology, 55, 689-692.
[48]  Vernon, G., Baranova, A. and Younossi, Z.M. (2011) The Epidemiology and Natural History of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis in Adults. Alimentary Pharmacology and Therapeutics, 34, 274-285.
[49]  Kabbany, M.N., Selvakumar, P.K.C., Watt, K., Lopez, R. Akras, Z., Zein, N., Carey, W. and Alkhouri, N. (2017) Prevalence of Nonalcoholic Steatohepatitis-Associated Cirrhosis in the United States: An Analysis of National Health and Nutrition Examination Survey Data. American College of Gastroenterology, 3, 1-7.
[50]  Kanwal, F., Kramer, J.R., Duan, Z., Yu, X., White, D. and El-Serag, H.B. (2016) Trends in the Burden of Non-Alcoholic Fatty Liver Disease in a US Cohort of Veterans. Clinical Gastroenterology Hepatology, 14, 301-308.
[51]  Harrison, S.A., Torgerson, S. and Hayashi, P.H. (2003) The Natural History of Nonalcoholic Fatty Liver Disease: A Clinical Histopathological Study. American Journal of Gastroenterology, 98, 2042-2047.
[52]  Liangpunsakul, S. and Chalasani, N. (2005) Unexplained Elevations in Alanine Aminotransferase in Individuals with the Metabolic Syndrome: Results from the Third National Health and Nutrition Survey (NHANES III). American Journal of Medical Science, 329, 111-116.
[53]  Day, C.P. (2012) Clinical Spectrum and Therapy of Non-Alcoholic Steatohepatitis. Digestive Disease and Science, 1, 69-73.
[54]  Bonci, E., Chiesa, C., Versacci, P., Anania, C., Silvestri., L. and Pacifio, L. (2015) Association of Nonalcoholic Fatty Liver Diseases with Subclinical Cardio Vascular Changes. Biomedical Research International, 8, 1-11.
[55]  Gambarin, G.M., Kinkhabwala, S.V., Schiano, T.D., Bodian, C., Yeh, H.C. and Futterweit, W. (2007) Spectrum of NAFLD and Diagnostic Implications of the Proposed New Normal Range for Serum ALT in Obese Women. Hepatology, 42, 650-656.
[56]  Williams, C.D., Stengel, J., Asike, M.I., Torres, D.M., Shaw, J., Contreras, M., Landt, C.L. and Harrison, S.A. (2011) Clinical Advances in Liver, Pancreas and Biliary Tract. Gastroenterology, 140, 124-131.
[57]  Bambha, K., Belt, P., Abraham, M., Wilson, L.A., Pabst, M., Ferrell, L., Unalp-Arida, A. and Bass, N. (2012) Ethnicity and Nonalcoholic Fatty Liver Disease. Hepatology, 55, 769-780.
[58]  Caserta, C.A., Mele, A., Surace, P., Ferrigno, L., Amante, A., Messineo, A., Vacalabre, C., Amato, F., Baldassare, D., Amato, M., Marcucci, F. and Zuin, M. (2017) Association of NAFLD and Cardio Metabolic RISL Factor with Early Artherosclerosis in an Adult Population in South Italy. Cardiovascular and Metabolic Risk, 53, 77-81.
[59]  Kulkina, E.V., Carroll, M.D., Shaw, K.M. and Hirschi, R. (2013) Trends in High LDL Cholesterol, Cholesterol Lowering Medication and Dietary Saturated Fat Intake in United States 1976-2010. Gastroenterology, 117, 1-8.
[60]  McPherson, S.T., Hardy, M.T., Henderson, E., Burt, A.D., Day, C.P. and Anstee, Q.M. (2015) Evidence of NAFLD Progression from Steatosis to Fibrosing-Steatohepatitis Using Paired Biopsies: Implications for Prognosis and Clinical Management. Journal of Hepatology, 62, 1148-1155.
[61]  Dassanayake, A.S., Kasthuriaratne, A., Rajendrajith, S., Kalubowila, V., Chakrawarthi, S., DeSilva, A.P., Makaya, M., Mizove, T., Kato, N., Wickramasinghe, A.R. and Desilva, H.J. (2009) Prevalence and Risk Factors for Non-Alcoholic Fatty Liver Disease among Adults in an Urban Srilankan Population. Journal of Gastroenterology and Hepatology, 24, 1284-1288.


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