An international multidisciplinary consensus statement on MAFLD and the risk of CVD.

Humans Cardiovascular Diseases / epidemiology Diabetes Mellitus, Type 2 / complications Asia Consensus Liver Diseases Non-alcoholic Fatty Liver Disease
Cardiovascular disease Consensus Delphi survey MAFLD Metabolic (dysfunction)-associated fatty liver disease Non-alcoholic fatty liver disease

Journal

Hepatology international
ISSN: 1936-0541
Titre abrégé: Hepatol Int
Pays: United States
ID NLM: 101304009

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 19 03 2023
accepted: 18 04 2023
medline: 31 7 2023
pubmed: 19 5 2023
entrez: 19 5 2023
Statut: ppublish

Résumé

Fatty liver disease in the absence of excessive alcohol consumption is an increasingly common condition with a global prevalence of ~ 25-30% and is also associated with cardiovascular disease (CVD). Since systemic metabolic dysfunction underlies its pathogenesis, the term metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed for this condition. MAFLD is closely intertwined with obesity, type 2 diabetes mellitus and atherogenic dyslipidemia, which are established cardiovascular risk factors. Unlike CVD, which has received attention in the literature on fatty liver disease, the CVD risk associated with MAFLD is often underestimated, especially among Cardiologists. A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management. The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research.

Sections du résumé

BACKGROUND BACKGROUND
Fatty liver disease in the absence of excessive alcohol consumption is an increasingly common condition with a global prevalence of ~ 25-30% and is also associated with cardiovascular disease (CVD). Since systemic metabolic dysfunction underlies its pathogenesis, the term metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed for this condition. MAFLD is closely intertwined with obesity, type 2 diabetes mellitus and atherogenic dyslipidemia, which are established cardiovascular risk factors. Unlike CVD, which has received attention in the literature on fatty liver disease, the CVD risk associated with MAFLD is often underestimated, especially among Cardiologists.
METHODS AND RESULTS RESULTS
A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management.
CONCULSIONS CONCLUSIONS
The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research.

Identifiants

DOI: 10.1007/s12072-023-10543-8 PMID: 37204656 PMC: PMC10198034
pubmed: 37204656
doi: 10.1007/s12072-023-10543-8
pii: 10.1007/s12072-023-10543-8
pmc: PMC10198034
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

773-791

Informations de copyright

© 2023. Asian Pacific Association for the Study of the Liver.

Références

Younossi Z, et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology (Baltimore, MD) 2016;64:73–84
pubmed: 26707365 doi: 10.1002/hep.28431
Chalasani N, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology (Baltimore, MD) 2018;67:328–357
pubmed: 28714183 doi: 10.1002/hep.29367
Eslam M, et al. A new definition for metabolic dysfunction-associated fatty liver disease: an international expert consensus statement. J Hepatol 2020;73:202–209
pubmed: 32278004 doi: 10.1016/j.jhep.2020.03.039
Zhang XL, Fan JG, Wei L, Shi JP, Zheng MH. Promoting the term MAFLD: China in action. Lancet Gastroenterol Hepatol 2022;7:598
pubmed: 35709820 doi: 10.1016/S2468-1253(22)00127-3
Eslam M, Sanyal AJ, George J. MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease. Gastroenterology 2020;158:1999-2014.e1
pubmed: 32044314 doi: 10.1053/j.gastro.2019.11.312
Zheng K, et al. From NAFLD to MAFLD: a “redefining” moment for fatty liver disease. Chin Med J 2020;133:2271–2273
pubmed: 32701591 pmcid: 7546877 doi: 10.1097/CM9.0000000000000981
Fouad Y, et al. The NAFLD-MAFLD debate: eminence vs evidence. Liver Int 2021;41:255–260
pubmed: 33220154 doi: 10.1111/liv.14739
Wang T, George J, Zheng M. Metabolic (dysfunction) associated fatty liver disease: more evidence and a bright future. Hepatobiliary Surg Nutr 2021;10:849–852
pubmed: 35004952 pmcid: 8683909 doi: 10.21037/hbsn-21-352
Tilg H, Effenberger M. From NAFLD to MAFLD: when pathophysiology succeeds. Nat Rev Gastroenterol Hepatol 2020;17:387–388
pubmed: 32461575 doi: 10.1038/s41575-020-0316-6
Zhou XD, et al. Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention. Cardiovasc Diabetol 2022;21:270
pubmed: 36463192 pmcid: 9719631 doi: 10.1186/s12933-022-01697-0
Chan W, Wong V. Meaning of non-overlapping patients between the MAFLD and NAFLD definitions. Liver Int 2022;42:271–273
pubmed: 35092337 doi: 10.1111/liv.15142
Wong VW, et al. Impact of the new definition of metabolic associated fatty liver disease on the epidemiology of the disease. Clin Gastroenterol Hepatol 2021;19:2161-2171.e5
pubmed: 33137486 doi: 10.1016/j.cgh.2020.10.046
Sun DQ, et al. MAFLD and risk of CKD. Metabolism 2021;115: 154433
pubmed: 33212070 doi: 10.1016/j.metabol.2020.154433
Zheng KI, Sun DQ, Jin Y, Zhu PW, Zheng MH. Clinical utility of the MAFLD definition. J Hepatol 2021;74:989–991
pubmed: 33347953 doi: 10.1016/j.jhep.2020.12.016
Das M. WHO urges immediate action to tackle non-communicable diseases. Lancet Oncol 2022;23:1361
pubmed: 36183734 doi: 10.1016/S1470-2045(22)00606-4
Lazarus J, et al. Advancing the global public health agenda for NAFLD: a consensus statement. Nat Rev Gastroenterol Hepatol 2022;19:60–78
pubmed: 34707258 doi: 10.1038/s41575-021-00523-4
Rubino F, et al. Joint international consensus statement for ending stigma of obesity. Nat Med 2020;26:485–497
pubmed: 32127716 pmcid: 7154011 doi: 10.1038/s41591-020-0803-x
Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med 2010;363:1341–1350
pubmed: 20879883 doi: 10.1056/NEJMra0912063
Targher G, Byrne C, Tilg H. NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications. Gut 2020;69:1691–1705
pubmed: 32321858 doi: 10.1136/gutjnl-2020-320622
Toh J, et al. A meta-analysis on the global prevalence, risk factors and screening of coronary heart disease in nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2022;20:2462-2473.e10
pubmed: 34560278 doi: 10.1016/j.cgh.2021.09.021
Wu S, et al. Association of non-alcoholic fatty liver disease with major adverse cardiovascular events: a systematic review and meta-analysis. Sci Rep 2016;6:33386
pubmed: 27633274 pmcid: 5026028 doi: 10.1038/srep33386
Targher G, Tilg H, Byrne CD. Non-alcoholic fatty liver disease: a multisystem disease requiring a multidisciplinary and holistic approach. Lancet Gastroenterol Hepatol 2021;6:578–588
pubmed: 33961787 doi: 10.1016/S2468-1253(21)00020-0
Mantovani A, et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021;6:903–913
pubmed: 34555346 doi: 10.1016/S2468-1253(21)00308-3
Zhou Y, et al. Nonalcoholic fatty liver disease contributes to subclinical atherosclerosis: a systematic review and meta-analysis. Hepatol Commun 2018;2:376–392
pubmed: 29619417 pmcid: 5880194 doi: 10.1002/hep4.1155
Kim H, et al. MAFLD predicts the risk of cardiovascular disease better than NAFLD in asymptomatic subjects with health check-ups. Dig Dis Sci 2022;67:4919
pubmed: 35579799 doi: 10.1007/s10620-022-07508-6
Huang Q, Zou X, Wen X, Zhou X, Ji L. NAFLD or MAFLD: which has closer association with all-cause and cause-specific mortality? Results from NHANES III. Front Med 2021;8: 693507
doi: 10.3389/fmed.2021.693507
Tsutsumi T, et al. MAFLD better predicts the progression of atherosclerotic cardiovascular risk than NAFLD: Generalized estimating equation approach. Hepatol Res 2021;51:1115–1128
pubmed: 34129272 doi: 10.1111/hepr.13685
Wang Y, et al. Cardiovascular and renal burdens among patients with MAFLD and NAFLD in China. Front Endocrinol (Lausanne) 2022;13:968766
pubmed: 36120461 doi: 10.3389/fendo.2022.968766
Yoneda M, et al. Risk of cardiovascular disease in patients with fatty liver disease as defined from the metabolic dysfunction associated fatty liver disease or nonalcoholic fatty liver disease point of view: a retrospective nationwide claims database study in Japan. J Gastroenterol 2021;56:1022–1032
pubmed: 34601620 pmcid: 8531127 doi: 10.1007/s00535-021-01828-6
Lee H, Lee YH, Kim SU, Kim HC. Metabolic dysfunction-associated fatty liver disease and incident cardiovascular disease risk: a nationwide cohort study. Clin Gastroenterol Hepatol 2021;19:2138-2147.e10
pubmed: 33348045 doi: 10.1016/j.cgh.2020.12.022
Liang Y, et al. Association of MAFLD With diabetes, chronic kidney disease, and cardiovascular disease: a 4.6-year cohort study in China. J Clin Endocrinol Metab 2022;107:88–97
pubmed: 34508601 doi: 10.1210/clinem/dgab641
Wen W, et al. Metabolic dysfunction-associated fatty liver disease and cardiovascular disease: a meta-analysis. Front Endocrinol (Lausanne) 2022;13:934225
pubmed: 36187109 doi: 10.3389/fendo.2022.934225
Targher G, Byrne CD, Lonardo A, Zoppini G, Barbui C. Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: a meta-analysis. J Hepatol 2016;65:589–600
pubmed: 27212244 doi: 10.1016/j.jhep.2016.05.013
Liu Y, Zhong GC, Tan HY, Hao FB, Hu JJ. Nonalcoholic fatty liver disease and mortality from all causes, cardiovascular disease, and cancer: a meta-analysis. Sci Rep 2019;9:11124
pubmed: 31366982 pmcid: 6668400 doi: 10.1038/s41598-019-47687-3
Kim D, et al. Metabolic dysfunction-associated fatty liver disease is associated with increased all-cause mortality in the United States. J Hepatol 2021;75:1284–1291
pubmed: 34380057 doi: 10.1016/j.jhep.2021.07.035
Niriella M, et al. Outcomes of NAFLD and MAFLD: results from a community-based, prospective cohort study. PLoS ONE 2021;16: e0245762
pubmed: 33534815 pmcid: 7857550 doi: 10.1371/journal.pone.0245762
Mantovani A, Csermely A, Tilg H, Byrne C, Targher G. Comparative effects of non-alcoholic fatty liver disease and metabolic dysfunction-associated fatty liver disease on risk of incident cardiovascular events: a meta-analysis of about 13 million individuals. Gut 2022. https://doi.org/10.1136/gutjnl-2022-328224
doi: 10.1136/gutjnl-2022-328224 pubmed: 36002249
Zhang H, Wang Y, Chen C, Lu Y, Wang N. Cardiovascular and renal burdens of metabolic associated fatty liver disease from serial US national surveys, 1999–2016. Chin Med J 2021;134:1593–1601
pubmed: 34091530 pmcid: 8280082 doi: 10.1097/CM9.0000000000001513
Nishimura K, et al. Predicting coronary heart disease using risk factor categories for a japanese urban population, and comparison with the Framingham risk score: the suita study. J Atheroscler Thromb 2016;23:1138–1139
pubmed: 27582077 doi: 10.5551/jat.Er19356
Angelico F, Baratta F, Pastori D, Ben MD. Assessment of hepatic fibrosis in MAFLD: A new player in the evaluation of residual cardiovascular risk? Dig Liver Dis 2021;53:383–384
pubmed: 33483258 doi: 10.1016/j.dld.2020.12.123
Schonmann Y, Yeshua H, Bentov I, Zelber-Sagi S. Liver fibrosis marker is an independent predictor of cardiovascular morbidity and mortality in the general population. Dig Liver Dis 2021;53:79–85
pubmed: 33144054 doi: 10.1016/j.dld.2020.10.014
Baratta F, et al. Nonalcoholic fatty liver disease and fibrosis associated with increased risk of cardiovascular events in a prospective study. Clin Gastroenterol Hepatol 2020;18:2324-2331.e4
pubmed: 31887443 doi: 10.1016/j.cgh.2019.12.026
Tamaki N, et al. Liver fibrosis and fatty liver as independent risk factors for cardiovascular disease. J Gastroenterol Hepatol 2021;36:2960–2966
pubmed: 34154037 doi: 10.1111/jgh.15589
Han E, et al. Fibrotic burden determines cardiovascular risk among subjects with metabolic dysfunction-associated fatty liver disease. Gut Liver 2022;16:786–797
pubmed: 35321955 pmcid: 9474484 doi: 10.5009/gnl210290
Ferro D, et al. New insights into the pathogenesis of non-alcoholic fatty liver disease: gut-derived lipopolysaccharides and oxidative stress. Nutrients 2020;12:2762
pubmed: 32927776 pmcid: 7551294 doi: 10.3390/nu12092762
Daniels SJ, et al. ADAPT: an algorithm incorporating PRO-C3 accurately identifies patients with NAFLD and advanced fibrosis. Hepatology 2019;69:1075–1086
pubmed: 30014517 doi: 10.1002/hep.30163
Parkes J, et al. Enhanced liver fibrosis test can predict clinical outcomes in patients with chronic liver disease. Gut 2010;59:1245–1251
pubmed: 20675693 doi: 10.1136/gut.2009.203166
Meyersohn NM, et al. Association of hepatic steatosis with major adverse cardiovascular events, independent of coronary artery disease. Clin Gastroenterol Hepatol 2021;19:1480-1488.e14
pubmed: 32707340 doi: 10.1016/j.cgh.2020.07.030
Kunutsor SK, Bakker SJL, Blokzijl H, Dullaart RPF. Associations of the fatty liver and hepatic steatosis indices with risk of cardiovascular disease: interrelationship with age. Clin Chim Acta 2017;466:54–60
pubmed: 28082024 doi: 10.1016/j.cca.2017.01.008
Zou B, Yeo Y, Cheung R, Ingelsson E, Nguyen M. Fatty liver index and development of cardiovascular disease: findings from the UK biobank. Dig Dis Sci 2021;66:2092–2100
pubmed: 33782808 doi: 10.1007/s10620-021-06954-y
Park J, et al. The associations of hepatic steatosis and fibrosis using fatty liver index and BARD score with cardiovascular outcomes and mortality in patients with new-onset type 2 diabetes: a nationwide cohort study. Cardiovasc Diabetol 2022;21:53
pubmed: 35429980 pmcid: 9013458 doi: 10.1186/s12933-022-01483-y
Moon JH, Kim W. Metabolic dysfunction-associated fatty liver disease predicts long-term mortality and cardiovascular disease. Gut Liver 2022;16:433–442
pubmed: 34635626 doi: 10.5009/gnl210167
Tang ASP, et al. Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: an updated meta-analysis with 135,602 individuals. Clin Mol Hepatol 2022;28:483–496
pubmed: 35232007 pmcid: 9293613 doi: 10.3350/cmh.2021.0406
Bessho R, et al. A significant risk of metabolic dysfunction-associated fatty liver disease plus diabetes on subclinical atherosclerosis. PLoS ONE 2022;17: e0269265
pubmed: 35639744 pmcid: 9154100 doi: 10.1371/journal.pone.0269265
Wang J, et al. New definition of metabolic dysfunction-associated fatty liver disease with elevated brachial-ankle pulse wave velocity and albuminuria: a prospective cohort study. Front Med 2022;16:714–722
pubmed: 35507246 doi: 10.1007/s11684-021-0888-8
Liu S, et al. The progression and regression of metabolic dysfunction-associated fatty liver disease are associated with the development of subclinical atherosclerosis: a prospective analysis. Metabolism 2021;120:154779
pubmed: 33895182 doi: 10.1016/j.metabol.2021.154779
Sung K, et al. Comparative associations of nonalcoholic fatty liver disease and metabolic dysfunction-associated fatty liver disease with coronary artery calcification: a cross-sectional and longitudinal cohort study. Arterioscler Thromb Vasc Biol 2023;43:482
pubmed: 36727522 doi: 10.1161/ATVBAHA.122.318661
Liu H, et al. Metabolic-associated fatty liver disease and major adverse cardiac events in patients with chronic coronary syndrome: a matched case-control study. Hep Int 2021;15:1337–1346
doi: 10.1007/s12072-021-10252-0
Noda T, et al. The prevalence of metabolic dysfunction-associated fatty liver disease and its association with physical function and prognosis in patients with acute coronary syndrome. J Clin Med 2022;11:1847
pubmed: 35407455 pmcid: 8999802 doi: 10.3390/jcm11071847
Nguyen VH, Le MH, Cheung RC, Nguyen MH. Differential clinical characteristics and mortality outcomes in persons with NAFLD and/or MAFLD. Clin Gastroenterol Hepatol 2021;19:2172-2181.e6
pubmed: 34033923 doi: 10.1016/j.cgh.2021.05.029
Gong H, Liu X, Cheng F. Relationship between non-alcoholic fatty liver disease and cardiac arrhythmia: a systematic review and meta-analysis. J Int Med Res 2021;49:3000605211047074
pubmed: 34590877 doi: 10.1177/03000605211047074
Lei F, et al. The prevalence of MAFLD and its association with atrial fibrillation in a nationwide health check-up population in China. Front Endocrinol (Lausanne) 2022;13:1007171
pubmed: 36237179 doi: 10.3389/fendo.2022.1007171
Decoin R, et al. High liver fibrosis scores in metabolic dysfunction-associated fatty liver disease patients are associated with adverse atrial remodeling and atrial fibrillation recurrence following catheter ablation. Front Endocrinol (Lausanne) 2022;13:957245
pubmed: 36120456 doi: 10.3389/fendo.2022.957245
Borges-Canha M, et al. Association between nonalcoholic fatty liver disease and cardiac function and structure-a meta-analysis. Endocrine 2019;66:467–476
pubmed: 31482382 doi: 10.1007/s12020-019-02070-0
Yong J, et al. Non-alcoholic fatty liver disease association with structural heart, systolic and diastolic dysfunction: a meta-analysis. Hep Int 2022;16:269–281
doi: 10.1007/s12072-022-10319-6
Peng D, et al. Association of metabolic dysfunction-associated fatty liver disease with left ventricular diastolic function and cardiac morphology. Front Endocrinol (Lausanne) 2022;13:935390
pubmed: 35928895 doi: 10.3389/fendo.2022.935390
Anstee Q, Mantovani A, Tilg H, Targher G. Risk of cardiomyopathy and cardiac arrhythmias in patients with nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol 2018;15:425–439
pubmed: 29713021 doi: 10.1038/s41575-018-0010-0
Mantovani A, et al. Risk of heart failure in patients with nonalcoholic fatty liver disease: JACC review topic of the week. J Am Coll Cardiol 2022;79:180–191
pubmed: 35027111 doi: 10.1016/j.jacc.2021.11.007
Stahl EP, et al. Nonalcoholic fatty liver disease and the heart: JACC state-of-the-art review. J Am Coll Cardiol 2019;73:948–963
pubmed: 30819364 doi: 10.1016/j.jacc.2018.11.050
Niederseer D, Wernly B, Aigner E, Stickel F, Datz C. NAFLD and cardiovascular diseases: epidemiological, mechanistic and therapeutic considerations. J Clin Med 2021;10:467
pubmed: 33530440 pmcid: 7865665 doi: 10.3390/jcm10030467
Siddiqui M, et al. Severity of nonalcoholic fatty liver disease and progression to cirrhosis are associated with atherogenic lipoprotein profile. Clin Gastroenterol Hepatol 2015;13:1000–8.e3
pubmed: 25311381 doi: 10.1016/j.cgh.2014.10.008
Cusi K. Role of obesity and lipotoxicity in the development of nonalcoholic steatohepatitis: pathophysiology and clinical implications. Gastroenterology 2012;142:711-725.e6
pubmed: 22326434 doi: 10.1053/j.gastro.2012.02.003
Austin MA, King MC, Vranizan KM, Krauss RM. Atherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk. Circulation 1990;82:495–506
pubmed: 2372896 doi: 10.1161/01.CIR.82.2.495
Gutiérrez-Cuevas J, Santos A, Armendariz-Borunda J. Pathophysiological molecular mechanisms of obesity: a link between MAFLD and NASH with cardiovascular diseases. Int J Mol Sci 2021;22:11629
pubmed: 34769060 pmcid: 8583943 doi: 10.3390/ijms222111629
Ormazabal V, et al. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol 2018;17:122
pubmed: 30170598 pmcid: 6119242 doi: 10.1186/s12933-018-0762-4
Goh G, et al. Renin-angiotensin system and fibrosis in non-alcoholic fatty liver disease. Liver Int 2015;35:979–985
pubmed: 24905085 doi: 10.1111/liv.12611
Paschos P, Tziomalos K. Nonalcoholic fatty liver disease and the renin-angiotensin system: implications for treatment. World J Hepatol 2012;4:327–331
pubmed: 23355909 pmcid: 3554795 doi: 10.4254/wjh.v4.i12.327
Attia H, et al. Chrysin attenuates fructose-induced nonalcoholic fatty liver in rats via antioxidant and anti-inflammatory effects: the role of angiotensin-converting enzyme 2/angiotensin (1–7)/mas receptor axis. Oxid Med Cell Longev 2022;2022:9479456
pubmed: 35720181 pmcid: 9200559 doi: 10.1155/2022/9479456
Zhang X, et al. Angiotensin-converting enzyme inhibitors prevent liver-related events in nonalcoholic fatty liver disease. Hepatology (Baltimore, MD) 2022;76:469–482
pubmed: 34939204 doi: 10.1002/hep.32294
Mantovani A, Dalbeni A. Treatments for NAFLD: state of art. Int J Mol Sci 2021;22:2350
pubmed: 33652942 pmcid: 7956331 doi: 10.3390/ijms22052350
Chew NWS, et al. The genetic interactions between non-alcoholic fatty liver disease and cardiovascular diseases. Front Genet 2022;13: 971484
pubmed: 36035124 pmcid: 9399730 doi: 10.3389/fgene.2022.971484
Anstee QM, Day CP. The genetics of nonalcoholic fatty liver disease: spotlight on PNPLA3 and TM6SF2. Semin Liver Dis 2015;35:270–290
pubmed: 26378644 doi: 10.1055/s-0035-1562947
Sookoian S, Pirola CJ. Meta-analysis of the influence of I148M variant of patatin-like phospholipase domain containing 3 gene (PNPLA3) on the susceptibility and histological severity of nonalcoholic fatty liver disease. Hepatology 2011;53:1883–1894
pubmed: 21381068 doi: 10.1002/hep.24283
Simons N, et al. PNPLA3, TM6SF2, and MBOAT7 genotypes and coronary artery disease. Gastroenterology 2017;152:912–913
pubmed: 28157516 doi: 10.1053/j.gastro.2016.12.020
Rüschenbaum S, et al. Patatin-like phospholipase domain containing 3 variants differentially impact metabolic traits in individuals at high risk for cardiovascular events. Hepatol Commun 2018;2:798–806
pubmed: 30027138 pmcid: 6049070 doi: 10.1002/hep4.1183
Liu D, et al. Exome-wide association study of plasma lipids in >300,000 individuals. Nat Genet 2017;49:1758–1766
pubmed: 29083408 pmcid: 5709146 doi: 10.1038/ng.3977
Kessler T, Schunkert H. Coronary artery disease genetics enlightened by genome-wide association studies. JACC Basic Transl Sci 2021;6:610–623
pubmed: 34368511 pmcid: 8326228 doi: 10.1016/j.jacbts.2021.04.001
Cai J, et al. Nonalcoholic fatty liver disease pandemic fuels the upsurge in cardiovascular diseases. Circ Res 2020;126:679–704
pubmed: 32105577 doi: 10.1161/CIRCRESAHA.119.316337
Drożdż K, et al. Metabolic-associated fatty liver disease (MAFLD), diabetes, and cardiovascular disease: associations with fructose metabolism and gut microbiota. Nutrients 2021;14:103
pubmed: 35010976 pmcid: 8746577 doi: 10.3390/nu14010103
Tang WHW, Bäckhed F, Landmesser U, Hazen SL. Intestinal microbiota in cardiovascular health and disease: JACC state-of-the-art review. J Am Coll Cardiol 2019;73:2089–2105
pubmed: 31023434 pmcid: 6518422 doi: 10.1016/j.jacc.2019.03.024
Reinhardt C. The gut microbiota as an influencing factor of arterial thrombosis. Hamostaseologie 2019;39:173–179
pubmed: 30458552 doi: 10.1055/s-0038-1675357
Albillos A, de Gottardi A, Rescigno M. The gut-liver axis in liver disease: Pathophysiological basis for therapy. J Hepatol 2020;72:558–577
pubmed: 31622696 doi: 10.1016/j.jhep.2019.10.003
Li F, Ye J, Shao C, Zhong B. Compositional alterations of gut microbiota in nonalcoholic fatty liver disease patients: a systematic review and meta-analysis. Lipids Health Dis 2021;20:22
pubmed: 33637088 pmcid: 7908766 doi: 10.1186/s12944-021-01440-w
Aron-Wisnewsky J, et al. Gut microbiota and human NAFLD: disentangling microbial signatures from metabolic disorders. Nat Rev Gastroenterol Hepatol 2020;17:279–297
pubmed: 32152478 doi: 10.1038/s41575-020-0269-9
Hu H, et al. Intestinal microbiome and NAFLD: molecular insights and therapeutic perspectives. J Gastroenterol 2020;55:142–158
pubmed: 31845054 doi: 10.1007/s00535-019-01649-8
Witkowski M, Weeks TL, Hazen SL. Gut microbiota and cardiovascular disease. Circ Res 2020;127:553–570
pubmed: 32762536 pmcid: 7416843 doi: 10.1161/CIRCRESAHA.120.316242
European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). Clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 2016;64:1388–402
Choudhary NS, Duseja A. Screening of cardiovascular disease in nonalcoholic fatty liver disease: whom and how? J Clin Exp Hepatol 2019;9:506–514
pubmed: 31516267 pmcid: 6728527 doi: 10.1016/j.jceh.2019.02.005
Hassen G, et al. Nonalcoholic fatty liver disease: an emerging modern-day risk factor for cardiovascular disease. Cureus 2022;14: e25495
pubmed: 35783879 pmcid: 9242599
Zaidi NR, Gilani SA, Mehboob R, Waseem H, Hassan A. Diagnostic accuracy of carotid intima media thickness by B-mode ultrasonography in coronary artery disease patients. Arch Med Sci Atheroscler Dis 2020;5:e79–e84
pubmed: 32529110 pmcid: 7277461 doi: 10.5114/amsad.2020.95651
den Ruijter HM, et al. Common carotid intima-media thickness does not add to Framingham risk score in individuals with diabetes mellitus: the USE-IMT initiative. Diabetologia 2013;56:1494–1502
doi: 10.1007/s00125-013-2898-9
Wu T, et al. Apolipoproteins and liver parameters optimize cardiovascular disease risk-stratification in nonalcoholic fatty liver disease. Dig Liver Dis 2021;53:1610–1619
pubmed: 33744170 doi: 10.1016/j.dld.2021.02.003
Pandyarajan V, Gish RG, Alkhouri N, Noureddin M. Screening for nonalcoholic fatty liver disease in the primary care clinic. Gastroenterol Hepatol (N Y) 2019;15:357–365
pubmed: 31391806
Zelber-Sagi S, Schonmann Y, Yeshua H, Bentov I. Reply to: “Assessment of hepatic fibrosis in MAFLD: a new player in the evaluation of residual cardiovascular risk?” Dig Liver Dis 2021;53:385–386
pubmed: 33509738 doi: 10.1016/j.dld.2021.01.014
Srivastava A, et al. Prospective evaluation of a primary care referral pathway for patients with non-alcoholic fatty liver disease. J Hepatol 2019;71:371–378
pubmed: 30965069 doi: 10.1016/j.jhep.2019.03.033
Harrison S, Allen A, Dubourg J, Noureddin M, Alkhouri N. Challenges and opportunities in NASH drug development. Nat Med 2023;29:562–573
pubmed: 36894650 doi: 10.1038/s41591-023-02242-6
Rivera-Esteban J, Armandi A, Augustin S, Bugianesi E. Outcomes and potential surrogate markers for future clinical trials of non-alcoholic steatohepatitis cirrhosis. Liver Int 2021;41:1999–2008
pubmed: 34242466 pmcid: 8457215 doi: 10.1111/liv.15013
Zhang XL, Wang TY, Targher G, Byrne CD, Zheng MH. Lifestyle interventions for non-obese patients both with, and at risk, of non-alcoholic fatty liver disease. Diabetes Metab J 2022;46:391–401
pubmed: 35656562 pmcid: 9171159 doi: 10.4093/dmj.2022.0048
Zou TT, et al. Lifestyle interventions for patients with nonalcoholic fatty liver disease: a network meta-analysis. Eur J Gastroenterol Hepatol 2018;30:747–755
pubmed: 29683979 doi: 10.1097/MEG.0000000000001135
Eslam M, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. Hepatol Int 2020;14:889–919
pubmed: 33006093 doi: 10.1007/s12072-020-10094-2
Petroni ML, Brodosi L, Bugianesi E, Marchesini G. Management of non-alcoholic fatty liver disease. BMJ 2021;372: m4747
pubmed: 33461969 doi: 10.1136/bmj.m4747
Baratta F, et al. Adherence to mediterranean diet and non-alcoholic fatty liver disease: effect on insulin resistance. Am J Gastroenterol 2017;112:1832–1839
pubmed: 29063908 doi: 10.1038/ajg.2017.371
Baratta F, et al. Poor adherence to Mediterranean Diet and serum lipopolysaccharide are associated with oxidative stress in patients with non-alcoholic fatty liver disease. Nutrients 2020;12:1732
pubmed: 32531941 pmcid: 7352324 doi: 10.3390/nu12061732
von Loeffelholz C, Roth J, Coldewey SM, Birkenfeld AL. The role of physical activity in nonalcoholic and metabolic dysfunction associated fatty liver disease. Biomedicines 2021;9:1853
doi: 10.3390/biomedicines9121853
Ajmera VH, Terrault NA, Harrison SA. Is moderate alcohol use in nonalcoholic fatty liver disease good or bad? A critical review. Hepatology 2017;65:2090–2099
pubmed: 28100008 doi: 10.1002/hep.29055
Chang Y, et al. Nonheavy drinking and worsening of noninvasive fibrosis markers in nonalcoholic fatty liver disease: a cohort study. Hepatology (Baltimore, MD) 2019;69:64–75
pubmed: 30019340 doi: 10.1002/hep.30170
Rice BA, Naimi TS, Long MT. Nonheavy alcohol use associates with liver fibrosis and nonalcoholic steatohepatitis in the Framingham heart study. Clin Gastroenterol Hepatol 2022. https://doi.org/10.1016/j.cgh.2022.10.039
doi: 10.1016/j.cgh.2022.10.039 pubmed: 36503167
Ajmera V, et al. Among patients with nonalcoholic fatty liver disease, modest alcohol use is associated with less improvement in histologic steatosis and steatohepatitis. Clin Gastroenterol Hepatol 2018;16:1511-1520.e5
pubmed: 29378307 pmcid: 6098737 doi: 10.1016/j.cgh.2018.01.026
Jarvis H, et al. Does moderate alcohol consumption accelerate the progression of liver disease in NAFLD? A systematic review and narrative synthesis. BMJ Open 2022;12: e049767
pubmed: 34983755 pmcid: 8728442 doi: 10.1136/bmjopen-2021-049767
Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G. Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis. J Am Coll Cardiol 2010;55:1339–1347
pubmed: 20338495 doi: 10.1016/j.jacc.2010.01.006
Wood AM, et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet 2018;391:1513–1523
pubmed: 29676281 pmcid: 5899998 doi: 10.1016/S0140-6736(18)30134-X
Hansel B, et al. Relationship between alcohol intake, health and social status and cardiovascular risk factors in the Urban Paris-Ile-de-France Cohort: is the cardioprotective action of alcohol a myth? Eur J Clin Nutr 2010;64:561–568
pubmed: 20485310 doi: 10.1038/ejcn.2010.61
Naimi TS, et al. Cardiovascular risk factors and confounders among nondrinking and moderate-drinking US adults. Am J Prev Med 2005;28:369–373
pubmed: 15831343 doi: 10.1016/j.amepre.2005.01.011
Biddinger KJ, et al. Association of habitual alcohol intake with risk of cardiovascular disease. JAMA Netw Open 2022;5: e223849
pubmed: 35333364 pmcid: 8956974 doi: 10.1001/jamanetworkopen.2022.3849
VanWagner LB, et al. Alcohol use and cardiovascular disease risk in patients with nonalcoholic fatty liver disease. Gastroenterology 2017;153:1260-1272.e3
pubmed: 28802566 doi: 10.1053/j.gastro.2017.08.012
Kashiwagi K, et al. Moderate alcohol consumption is not associated with subclinical cardiovascular damage but with hepatic fibrosis in non-alcoholic fatty liver disease. Alcohol 2020;89:1–7
pubmed: 32738385 doi: 10.1016/j.alcohol.2020.07.010
Moon J, et al. SGLT-2 inhibitors and GLP-1 receptor agonists in metabolic dysfunction-associated fatty liver disease. Trends Endocrinol Metab 2022;33:424–442
pubmed: 35491295 doi: 10.1016/j.tem.2022.03.005
Yan J, et al. Liraglutide, sitagliptin, and insulin glargine added to metformin: the effect on body weight and intrahepatic lipid in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease. Hepatology (Baltimore, MD) 2019;69:2414–2426
pubmed: 30341767 doi: 10.1002/hep.30320
Kristensen SL, et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol 2019;7:776–785
pubmed: 31422062 doi: 10.1016/S2213-8587(19)30249-9
Bethel MA, et al. Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis. Lancet Diabetes Endocrinol 2018;6:105–113
pubmed: 29221659 doi: 10.1016/S2213-8587(17)30412-6
Armstrong MJ, et al. Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet 2016;387:679–690
pubmed: 26608256 doi: 10.1016/S0140-6736(15)00803-X
Newsome PN, et al. A placebo-controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis. N Engl J Med 2021;384:1113–1124
pubmed: 33185364 doi: 10.1056/NEJMoa2028395
Mantovani A, et al. Glucagon-like peptide-1 receptor agonists for treatment of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: an updated meta-analysis of randomized controlled trials. Metabolites 2021;11:73
pubmed: 33513761 pmcid: 7911747 doi: 10.3390/metabo11020073
Scheen AJ. Sodium-glucose cotransporter type 2 inhibitors for the treatment of type 2 diabetes mellitus. Nat Rev Endocrinol 2020;16:556–577
pubmed: 32855502 doi: 10.1038/s41574-020-0392-2
Zelniker TA, Braunwald E. Clinical benefit of cardiorenal effects of sodium-glucose cotransporter 2 inhibitors: JACC state-of-the-art review. J Am Coll Cardiol 2020;75:435–447
pubmed: 32000956 doi: 10.1016/j.jacc.2019.11.036
Zelniker TA, et al. Comparison of the effects of glucagon-like peptide receptor agonists and sodium-glucose cotransporter 2 inhibitors for prevention of major adverse cardiovascular and renal outcomes in type 2 diabetes mellitus. Circulation 2019;139:2022–2031
pubmed: 30786725 doi: 10.1161/CIRCULATIONAHA.118.038868
Zelniker TA, Braunwald E. Mechanisms of cardiorenal effects of sodium-glucose cotransporter 2 inhibitors: JACC state-of-the-art review. J Am Coll Cardiol 2020;75:422–434
pubmed: 32000955 doi: 10.1016/j.jacc.2019.11.031
Bolinder J, et al. Effects of dapagliflozin on body weight, total fat mass, and regional adipose tissue distribution in patients with type 2 diabetes mellitus with inadequate glycemic control on metformin. J Clin Endocrinol Metab 2012;97:1020–1031
pubmed: 22238392 doi: 10.1210/jc.2011-2260
Lai LL, Vethakkan SR, Nik Mustapha NR, Mahadeva S, Chan WK. Empagliflozin for the treatment of nonalcoholic steatohepatitis in patients with type 2 diabetes mellitus. Dig Dis Sci 2020;65:623–631
pubmed: 30684076 doi: 10.1007/s10620-019-5477-1
Mantovani A, Petracca G, Csermely A, Beatrice G, Targher G. Sodium-glucose cotransporter-2 inhibitors for treatment of nonalcoholic fatty liver disease: a meta-analysis of randomized controlled trials. Metabolites 2020;11:22
pubmed: 33396949 pmcid: 7823667 doi: 10.3390/metabo11010022
Belfort R, et al. A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis. N Engl J Med 2006;355:2297–2307
pubmed: 17135584 doi: 10.1056/NEJMoa060326
Young LH, et al. Cardiac outcomes after ischemic stroke or transient ischemic attack: effects of pioglitazone in patients with insulin resistance without diabetes mellitus. Circulation 2017;135:1882–1893
pubmed: 28246237 pmcid: 5511545 doi: 10.1161/CIRCULATIONAHA.116.024863
Young LH, et al. Heart failure after ischemic stroke or transient ischemic attack in insulin-resistant patients without diabetes mellitus treated with pioglitazone. Circulation 2018;138:1210–1220
pubmed: 29934374 pmcid: 6202153 doi: 10.1161/CIRCULATIONAHA.118.034763
Mehtälä J, et al. Pioglitazone use and risk of bladder cancer: a systematic literature review and meta-analysis of observational studies. Diabetol Int 2019;10:24–36
pubmed: 30800561 doi: 10.1007/s13340-018-0360-4
Portillo-Sanchez P, et al. Effect of pioglitazone on bone mineral density in patients with nonalcoholic steatohepatitis: a 36-month clinical trial. J Diabetes 2019;11:223–231
pubmed: 30073778 doi: 10.1111/1753-0407.12833
Jacques V, et al. Deuterium-stabilized (R)-pioglitazone (PXL065) Is responsible for pioglitazone efficacy in NASH yet exhibits little to no PPARγ activity. Hepatol Commun 2021;5:1412–1425
pubmed: 34430785 pmcid: 8369945 doi: 10.1002/hep4.1723
Grundy SM, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2019;139:e1082–e1143
pubmed: 30586774
Pastori D, et al. Statin liver safety in non-alcoholic fatty liver disease: a systematic review and metanalysis. Br J Clin Pharmacol 2022;88:441–451
pubmed: 34133035 doi: 10.1111/bcp.14943
Athyros VG, et al. Safety and efficacy of long-term statin treatment for cardiovascular events in patients with coronary heart disease and abnormal liver tests in the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) Study: a post-hoc analysis. Lancet 2010;376:1916–1922
pubmed: 21109302 doi: 10.1016/S0140-6736(10)61272-X
Fatima K, et al. Efficacy of statins in treatment and development of non-alcoholic fatty liver disease and steatohepatitis: a systematic review and meta-analysis. Clin Res Hepatol Gastroenterol 2021;46: 101816
pubmed: 34607067 doi: 10.1016/j.clinre.2021.101816
Khoo S, et al. Suboptimal treatment of dyslipidemia in patients with nonalcoholic fatty liver disease. J Gastroenterol Hepatol 2020;35:320–325
pubmed: 31336392 doi: 10.1111/jgh.14794
Du J, Ma YY, Yu CH, Li YM. Effects of pentoxifylline on nonalcoholic fatty liver disease: a meta-analysis. World J Gastroenterol 2014;20:569–577
pubmed: 24574727 pmcid: 3923033 doi: 10.3748/wjg.v20.i2.569
Vilar-Gomez E, et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology 2015;149:367–378
pubmed: 25865049 doi: 10.1053/j.gastro.2015.04.005
Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and risks of bariatric surgery in adults: a review. JAMA 2020;324:879–887
pubmed: 32870301 doi: 10.1001/jama.2020.12567
Aminian A, et al. Association of bariatric surgery with major adverse liver and cardiovascular outcomes in patients with biopsy-proven nonalcoholic steatohepatitis. JAMA 2021;326:2031–2042
pubmed: 34762106 pmcid: 8587225 doi: 10.1001/jama.2021.19569
Elsaid M, et al. Association of bariatric surgery with cardiovascular outcomes in adults with severe obesity and nonalcoholic fatty liver disease. JAMA Netw Open 2022;5: e2235003
pubmed: 36205997 pmcid: 9547320 doi: 10.1001/jamanetworkopen.2022.35003

Auteurs

Xiao-Dong Zhou (XD)

Department of Cardiovascular Medicine, The Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Giovanni Targher (G)

Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism, University of Verona, Verona, Italy.

Christopher D Byrne (CD)

Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK.

Virend Somers (V)

Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, USA.

Seung Up Kim (SU)

Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.

C Anwar A Chahal (CAA)

Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, USA.
Center for Inherited Cardiovascular Diseases, WellSpan Health, Lancaster, PA, USA.
Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, EC1A 7BE, West Smithfield, UK.

Vincent Wai-Sun Wong (VW)

State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.

Jingjing Cai (J)

Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China.

Michael D Shapiro (MD)

Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Mohammed Eslam (M)

Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, 2145, Australia.

Philippe Gabriel Steg (PG)

Université Paris -Cité, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM U1148, Paris, France.

Ki-Chul Sung (KC)

Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Anoop Misra (A)

Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation (India), New Delhi, India.

Jian-Jun Li (JJ)

State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Carlos Brotons (C)

Biomedical Research Institute Sant Pau (IIB Sant Pau), Sardenya Primary Health Care Center, Barcelona, Spain.

Yuli Huang (Y)

Department of Cardiology, Shunde Hospital, Southern Medical University, Jiazi Road, Lunjiao Town, Shunde District, Foshan, China.

George V Papatheodoridis (GV)

Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece.

Aijun Sun (A)

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.

Yusuf Yilmaz (Y)

Institute of Gastroenterology, Marmara University, Istanbul, Turkey.
Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.

Wah Kheong Chan (WK)

Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Hui Huang (H)

Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, 3025 Shennan Middle Road, Shenzhen, China.

Nahum Méndez-Sánchez (N)

Liver Research Unit, Medica Sur Clinic and Foundation and Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.

Saleh A Alqahtani (SA)

Liver Transplantation Unit, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Baltimore, MD, USA.

Helena Cortez-Pinto (H)

Laboratório de Nutrição e Metabolismo, Faculdade de Medicina, Clínica Universitária de Gastrenterologia, Universidade de Lisboa, Lisbon, Portugal.

Gregory Y H Lip (GYH)

Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK.
Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Robert J de Knegt (RJ)

Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Gravendijkwal 230, Room Ha 206, Rotterdam, The Netherlands.

Ponsiano Ocama (P)

Department of Internal Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Manuel Romero-Gomez (M)

Department of Digestive and Liver Diseases, Institute of Biomedicine of Seville, University Hospital Virgen del Rocio, University of Seville, Seville, Spain.

Marat Fudim (M)

Department of Cardiology, Duke University School of Medicine, Durham, NC, USA.
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.

Giada Sebastiani (G)

Division of Gastroenterology and Hepatology, Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital, 1001 Blvd. Décarie, Montreal, Canada.

Jang Won Son (JW)

Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

John D Ryan (JD)

Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland.

Ignatios Ikonomidis (I)

Preventive Cardiology Laboratory and Cardiometabolic Clinic, Second Cardiology Department, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Sombat Treeprasertsuk (S)

Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.

Daniele Pastori (D)

Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.

Monica Lupsor-Platon (M)

Department of Medical Imaging, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Herbert Tilg (H)

Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University Innsbruck, Innsbruck, Austria.

Hasmik Ghazinyan (H)

Department of Hepatology, Nork Clinical Hospital of Infectious Disease, Yerevan, Armenia.

Jerome Boursier (J)

Hepato-Gastroenterology Department, University Hospital, 4 Larrey Street, 49933, Angers Cedex 09, France.
HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.

Masahide Hamaguchi (M)

Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, Japan.

Mindie H Nguyen (MH)

Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.
Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, CA, USA.

Jian-Gao Fan (JG)

Center for Fatty Liver, Department of Gastroenterology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

George Boon-Bee Goh (GB)

Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore.

Mamun Al Mahtab (M)

Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Saeed Hamid (S)

Department of Medicine, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.

Nilanka Perera (N)

Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.

Jacob George (J)

Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, 2145, Australia. jacob.george@sydney.edu.au.

Ming-Hua Zheng (MH)

MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, No. 2 Fuxue Lane, Wenzhou, 325000, China. zhengmh@wmu.edu.cn.
Institute of Hepatology, Wenzhou Medical University, Wenzhou, China. zhengmh@wmu.edu.cn.
Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China. zhengmh@wmu.edu.cn.
ORCID: 0000-0003-4984-2631

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › An international multidisciplinary consensus...
questionsmedicales.fr › Maladies cardiovasculaires › An international multidisciplinary consensus...
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questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › An international multidisciplinary consensus...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Stéatose hépatique › Stéatose hépatique non alcoolique › An international multidisciplinary consensus...