| Abstract [eng] |
Background. Metabolic syndrome is a cluster of cardiovascular risk factors that includes abdominal obesity, dyslipidaemia, arterial hypertension and higher glucose levels. Currently, there is growing evidence of a close relationship between metabolic syndrome and non-alcoholic fatty liver disease. Obesity, dyslipidaemia, type 2 diabetes, and insulin resistance have been identified as risk factors for the development of non-alcoholic fatty liver disease. Therefore in 2020, an expert panel proposed a definition for metabolic dysfunction-associated fatty liver disease. Objective. To describe nonalcoholic fatty liver disease, its relationship with metabolic syndrome (or its components) and present a clinical case of metabolic dysfunction-associated fatty liver disease. Material and methods. A review of scientific publications was performed and a clinical case of non-alcoholic fatty liver disease with signs of metabolic syndrome was described. Articles were collected from PubMed, Embase, ScienceDirect and ClinicalKey databases. Results. Results of the reviewed scientific publications showed that over half of the individuals with non-alcoholic fatty liver disease had metabolic syndrome or its components, including arterial hypertension, type 2 diabetes, dyslipidaemia, and obesity. Studies showed that non-alcoholic fatty liver disease is linked to atherogenic dyslipidaemia. Furthermore, it was proven that atherogenic dyslipidaemia is associated with liver fibrosis in subjects with non-alcoholic fatty liver disease and type 2 diabetes. The patient described in the clinical case was diagnosed with non-alcoholic steatohepatitis and metabolic syndrome. Following the latest recommendations, the patient could be diagnosed with metabolic dysfunction-associated fatty liver disease as no other possible pathologies were identified. Conclusions. Metabolic syndrome is prevalent in more than half of patients with non-alcoholic fatty liver disease. Patients with nonalcoholic fatty liver disease and metabolic syndrome have more advanced liver fibrosis, therefore once metabolic syndrome is diagnosed, screening for nonalcoholic fatty liver disease is recommended and vice versa. According to the updated programme of primary prevention of cardiovascular diseases in Lithuania, people at very high risk of cardiovascular disease will have their liver enzymes tested. Statins are safe to use for individuals with nonalcoholic fatty liver disease and elevated transaminase levels. Statins slow down the progression of fibrosis, the development of non-alcoholic steatohepatitis and reduce the risk of cardiovascular diseases. Following the latest guidelines, the presence of hepatic steatosis and obesity (or overweight) or type 2 diabetes or at least 2 metabolic risk factors leads to the diagnosis of metabolic dysfunction-associated fatty liver disease. Keywords: metabolic syndrome, non-alcoholic fatty liver disease, NAFLD, metabolic dysfunction-associated fatty liver disease, MAFLD, arterial hypertension, dyslipidaemia, type 2 diabetes, obesity, cardiometabolic risk. |
