Intrahepatic vascular changes in non-alcoholic fatty liver disease: potential role of insulin-resistance and endothelial dysfunction

Metabolic syndrome is a cluster of several clinical conditions characterized by insulin-resistance and high cardiovascular risk. Non-alcoholic fatty liver disease is the liver expression of the metabolic syndrome, and insulin resistance can be a frequent comorbidity in several chronic liver diseases...

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Published inWorld journal of gastroenterology : WJG Vol. 23; no. 37; pp. 6777 - 6787
Main Authors Pasarín, Marcos, Abraldes, Juan G, Liguori, Eleonora, Kok, Beverley, La Mura, Vincenzo
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 07.10.2017
Subjects
Review
Endothelial dysfunction
Insulin resistance
Metabolic syndrome
Non-alcoholic fatty liver disease
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Summary:Metabolic syndrome is a cluster of several clinical conditions characterized by insulin-resistance and high cardiovascular risk. Non-alcoholic fatty liver disease is the liver expression of the metabolic syndrome, and insulin resistance can be a frequent comorbidity in several chronic liver diseases, in particular hepatitis C virus infection and/or cirrhosis. Several studies have demonstrated that insulin action is not only relevant for glucose control, but also for vascular homeostasis. Insulin regulates nitric oxide production, which mediates to a large degree the vasodilating, antiinflammatory and antithrombotic properties of a healthy endothelium, guaranteeing organ perfusion. The effects of insulin on the liver microvasculature and the effects of IR on sinusoidal endothelial cells have been studied in animal models of non-alcoholic fatty liver disease. The hypotheses derived from these studies and the potential translation of these results into humans are critically discussed in this review.
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Author contributions: Pasarín M and La Mura V contributed to systematic review of literature, design and writing of the manuscript; Abraldes JG contributed to revision of the major intellectual contents; Kok B contributed to edition of the language (as mother tongue), revision of the major intellectual contents; Liguori E contributed to edition of the paper, figures and systematic review of literature; and La Mura V contributed to supervision of the manuscript edition.
Telephone: +39-02-52774317
Correspondence to: Vincenzo La Mura, MD, PhD, Assistant Professor, Internal Medicine, IRCCS San Donato, Department of Biomedical Sciences for Health, University of Milan, p.zza Edmondo Malan, 1, 20097 San Donato Milanese, Italy. vincenzo.lamura@unimi.it
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v23.i37.6777