Bart Staels, PhD of Univ of Lille, France gave an outstanding talk on Interplay Between #NAFLD & #CVD at the #WCIRDC. CVD is the leading cause of death not liver disease. Fibrosis severity correlates with higher CVD risk. @WCIRDC @YHandelsmanMD
healio.com/news/endocrino…
Type 2 #diabetes and #NAFLD have a reciprocally injurious relationship mediated through common pathophysiology magnifying the risk for #CVD events.
pubmed.ncbi.nlm.nih.gov/33015726/ @zilbermint @AlinaAllenMD
#NAFLD is considered the hepatic manifestation of the metabolic syndrome and is closely linked to:
#Obesity, especially visceral adiposity
✅Insulin resistance
✅Chronic inflammation
#Lipotoxicity
nature.com/articles/s4141…
NAFLD is associated with an especially atherogenic #dyslipidemia and milieu for #CVD:
✅↑ VLDL
✅Hypertriglyceridemia
✅Small dense LDL
✅↓ HDL
✅Endothelial dysfunction
✅Prothrombotic state
sciencedirect.com/science/articl…
The leading cause of death in patients with NAFLD is #CVD, not liver disease. The increased risk of both fatal and nonfatal CV events in #NAFLD and #NASH has been correlated with the severity of hepatic steatosis, inflammation, or fibrosis. @TheAACE
sciencedirect.com/science/articl…
In #NAFLD, more severe liver disease increases #CVD risk. Both CV and liver events are highly related to the degree of hepatic fibrosis. @EndocrineToday @AlkhouriNaim @DrLoomba @NoureddinMD @Mayo_liverdoc
healio.com/news/cardiolog…
The FIB-4 score predicts #CVD risk in #NAFLD, patients with high FIB-4 have a 4-fold increased risk.
pubmed.ncbi.nlm.nih.gov/31887443/ @DrKarlNadolsky @DrNadolsky @rabataller @FattyLiverA @LiverSaver
#CVD and #Obesity
✅Atrial fibrillation
✅Ventricular arrhythmias
✅Heart failure with preserved ejection fraction
✅Cardiomyopathy
✅Cardiac fibrosis
✅Cardiac valvular calcification
pubmed.ncbi.nlm.nih.gov/36007112/
@BevTchangMD @monicaagar21 @JaimeAlmandoz @ErinMichos
It is difficult to establish a causal relationship between #NAFLD and #CVD, given the entanglement of overlapping metabolic disturbances in these individuals. @EndocrineToday @TheAACE #livertwitter #endotwitter #CardioTwitter
healio.com/news/cardiolog…

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More from @scottisaacsmd

Sep 19
Thyroid hormones regulate liver enzymes via thyroid hormone receptors. When the liver is steatotic, hepatic thyroid hormone receptors don’t respond effectively. This results in an intrahepatic hormonal milieu where the liver is essentially hypothyroid. #livertwitter #endotwitter
Thyroid hormone receptor-β plays a key role in hepatic homeostasis including:
✅De novo lipogenesis
✅Fatty acid β-oxidation
✅Mitophagy
✅Mitochondrial biogenesis
✅Cholesterol metabolism
✅Carbohydrate metabolism
#livertwitter #endotwitter
Thyroid hormone receptor-β agonism has demonstrated clinical benefits on hepatic lipid metabolism.
frontiersin.org/articles/10.33…
Read 12 tweets
Sep 4
Thyroid hormones regulate liver enzymes. When the liver is fatty, thyroid hormones don’t work right. #HepaticHypothyroidism
Hepatic enzymes responsive to #thyroid hormones will slow down when the liver is fatty. Thyroid hormone has a dominant effect on HMG-CoA reductase in the liver which regulates cholesterol levels which is why #hypothyroidism causes high cholesterol. #HepaticHypothyroidism
Thyroid hormone regulates fatty acid β-oxidation in the liver. This is a process that breaks down fat for energy. #NAFLD impedes the process in a viscous cycle where liver fat continues to build up, energy levels plummet, unresponsive to thyroid hormone. #HepaticHypothyroidism
Read 10 tweets

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