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Non-alcoholic fatty liver disease and cardiovascular disease: assessing the evidence for causality – published online 11/11/2019

Martijn C. G. J. Brouwers, Nynke Simons, Coen D. A. Stehouwer, Aaron Isaacs

Non-alcoholic fatty liver disease (NAFLD) has emerged as a risk factor for type 2 diabetes and cardiovascular disease (CVD). In this issue, Brouwers and colleagues (https://doi.org/10.1007/s00125-019-05024-3) elaborate on potential mediators of the relationship between NAFLD and CVD, such as plasma lipids, low-grade inflammation, impaired fibrinolysis and hepatokines. By summarising recent advances in genetic studies that focused on the relationship between NAFLD susceptibility genes (PNPLA3, TM6SF2, GCKR and MBOAT7) and CVD, it appears that plasma lipids are an important mediator of that relationship. This has therapeutic implications, particularly for the design of anti-NAFLD drugs that affect lipid metabolism. Since these agents are aimed primarily at preventing end-stage liver disease, it is important to underscore the fact that the principal cause of death in individuals with NAFLD is CVD. The figures from this review are available as a downloadable slideset.

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