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PMID: 17659704 Published · ppublish English Editorial Review

Metabolic liver disease of obesity and role of adipose tissue in the pathogenesis of nonalcoholic fatty liver disease.

World journal of gastroenterology ·Vol. 13 ·No. 26 ·2007-07-14 ·Pages 3540-53

Qureshi K, Abrams GA

Abstract

Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized cause of liver-related morbidity and mortality. It can develop secondary to numerous causes but a great majority of NAFLD cases occur in patients who are obese or present with other components of metabolic syndrome (hypertension, dyslipidemia, diabetes). This is called primary NAFLD and insulin resistance plays a key role in its pathogenesis. Obesity is characterized by expanded adipose tissue, which is under a state of chronic inflammation. This disturbs the normal storage and endocrine functions of adipose tissue. In obesity, the secretome (adipokines, cytokines, free fatty acids and other lipid moieties) of fatty tissue is amplified, which through its autocrine, paracrine actions in fat tissue and systemic effects especially in the liver leads to an altered metabolic state with insulin resistance (IR). IR leads to hyperglycemia and reactive hyperinsulinemia, which stimulates lipid-accumulating processes and impairs hepatic lipid metabolism. IR enhances free fatty acid delivery to liver from the adipose tissue storage due to uninhibited lipolysis. These changes result in hepatic abnormal fat accumulation, which may initiate the hepatic IR and further aggravate the altered metabolic state of whole body. Hepatic steatosis can also be explained by the fact that there is enhanced dietary fat delivery and physical inactivity. IR and NAFLD are also seen in various lipodystrophic states in contrary to popular belief that these problems only occur due to excessive adiposity in obesity. Hence, altered physiology of adipose tissue is central to development of IR, metabolic syndrome and NAFLD.

MeSH Terms
Adipose Tissue/metabolism,pathology,physiopathology Chronic Disease Fatty Liver/etiology Humans Inflammation/complications Insulin Resistance Life Style Lipid Metabolism Liver/metabolism Metabolic Syndrome/complications Obesity/complications
Authors & Affiliations
2 authors, click to expand affiliations / ORCID
Qureshi Kamran
Department of Medicine, University of Alabama at Birmingham, 1918 University Blvd 286 MCLM Birmingham, AL 35294, USA.
Abrams Gary A
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Article Info
Journal
World journal of gastroenterology
Abbr.
World J Gastroenterol
ISSN
1007-9327
DOI
10.3748/wjg.v13.i26.3540
Published
2007-07-14
Pages
3540-53
Language
English
Region
United States
NLM ID
100883448
PMCID
PMC4146793
Subset
IM
External Links
PubMed source DOI: 10.3748/wjg.v13.i26.3540 PMC Full Text View journal details
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