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Non-alcoholic fatty liver disease: a multi-system disease influenced by ageing and sex, and affected by adipose tissue and intestinal function

Non-alcoholic fatty liver disease: a multi-system disease influenced by ageing and sex, and affected by adipose tissue and intestinal function
Non-alcoholic fatty liver disease: a multi-system disease influenced by ageing and sex, and affected by adipose tissue and intestinal function

In recent years, a wealth of factors are associated with increased risk of developing non-alcoholic fatty liver disease (NAFLD) and NAFLD is now thought to increase the risk of multiple extra-hepatic diseases. The aim of this review is firstly to focus on the role of ageing and sex as key, poorly understood risk factors in the development and progression of NAFLD. Secondly, we aim to discuss the roles of white adipose tissue (WAT) and intestinal dysfunction, as producers of extra-hepatic factors known to further contribute to the pathogenesis of NAFLD. Finally, we aim to summarise the role of NAFLD as a multi-system disease affecting other organ systems beyond the liver. Both increased age and male sex increase the risk of NAFLD and this may be partly driven by alterations in the distribution and function of WAT. Similarly, changes in gut microbiota (GM) composition and intestinal function with ageing and chronic overnutrition are likely to contribute to the development of NAFLD both directly (i.e. by affecting hepatic function) and indirectly via exacerbating WAT dysfunction. Consequently, the presence of NAFLD significantly increases the risk of various extra-hepatic diseases including cardiovascular disease, type 2 diabetes mellitus, chronic kidney disease and certain extra-hepatic cancers. Thus changes in WAT and intestinal function with ageing and chronic overnutrition contribute to the development of NAFLD - a multi-system disease that subsequently contributes to the development of other chronic cardiometabolic diseases.

Non-alcoholic fatty liver disease, adipose tissue dysfunction, age, cardiovascular disease, diabetes, gut microbiota, sex
0029-6651
146-161
Bilson, Josh
1132faa9-9276-48c7-8d44-ad38dbf1a63a
Sethi, Jaswinder K.
923f1a81-91e4-46cd-8853-bb4a979f5a85
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Bilson, Josh
1132faa9-9276-48c7-8d44-ad38dbf1a63a
Sethi, Jaswinder K.
923f1a81-91e4-46cd-8853-bb4a979f5a85
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c

Bilson, Josh, Sethi, Jaswinder K. and Byrne, Christopher (2022) Non-alcoholic fatty liver disease: a multi-system disease influenced by ageing and sex, and affected by adipose tissue and intestinal function. Proceedings of the Nutrition Society, 81 (2), 146-161. (doi:10.1017/S0029665121003815).

Record type: Article

Abstract

In recent years, a wealth of factors are associated with increased risk of developing non-alcoholic fatty liver disease (NAFLD) and NAFLD is now thought to increase the risk of multiple extra-hepatic diseases. The aim of this review is firstly to focus on the role of ageing and sex as key, poorly understood risk factors in the development and progression of NAFLD. Secondly, we aim to discuss the roles of white adipose tissue (WAT) and intestinal dysfunction, as producers of extra-hepatic factors known to further contribute to the pathogenesis of NAFLD. Finally, we aim to summarise the role of NAFLD as a multi-system disease affecting other organ systems beyond the liver. Both increased age and male sex increase the risk of NAFLD and this may be partly driven by alterations in the distribution and function of WAT. Similarly, changes in gut microbiota (GM) composition and intestinal function with ageing and chronic overnutrition are likely to contribute to the development of NAFLD both directly (i.e. by affecting hepatic function) and indirectly via exacerbating WAT dysfunction. Consequently, the presence of NAFLD significantly increases the risk of various extra-hepatic diseases including cardiovascular disease, type 2 diabetes mellitus, chronic kidney disease and certain extra-hepatic cancers. Thus changes in WAT and intestinal function with ageing and chronic overnutrition contribute to the development of NAFLD - a multi-system disease that subsequently contributes to the development of other chronic cardiometabolic diseases.

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20211102_NAFLD_Review_Final - Accepted Manuscript
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Accepted/In Press date: 5 November 2021
e-pub ahead of print date: 22 November 2021
Published date: May 2022
Additional Information: Publisher Copyright: © 2021 Cambridge University Press. All rights reserved.
Keywords: Non-alcoholic fatty liver disease, adipose tissue dysfunction, age, cardiovascular disease, diabetes, gut microbiota, sex

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Local EPrints ID: 452830
URI: http://eprints.soton.ac.uk/id/eprint/452830
ISSN: 0029-6651
PURE UUID: ef3d9949-31eb-4f0a-8ca0-3f2369f6d456
ORCID for Josh Bilson: ORCID iD orcid.org/0000-0003-4665-3886
ORCID for Jaswinder K. Sethi: ORCID iD orcid.org/0000-0003-4157-0475
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 21 Dec 2021 17:51
Last modified: 07 Jan 2023 03:00

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Author: Josh Bilson ORCID iD

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