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Published in: BMC Medicine 1/2020

Open Access 01-12-2020 | Fatty Liver | Review

Non-alcoholic fatty liver disease (NAFLD) as a neglected metabolic companion of psychiatric disorders: common pathways and future approaches

Authors: Óscar Soto-Angona, Gerard Anmella, María José Valdés-Florido, Nieves De Uribe-Viloria, Andre F. Carvalho, Brenda W. J. H. Penninx, Michael Berk

Published in: BMC Medicine | Issue 1/2020

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Abstract

Background

Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic steatosis in over 5% of the parenchyma in the absence of excessive alcohol consumption. It is more prevalent in patients with diverse mental disorders, being part of the comorbidity driving loss of life expectancy and quality of life, yet remains a neglected entity. NAFLD can progress to non-alcoholic steatohepatitis (NASH) and increases the risk for cirrhosis and hepatic carcinoma. Both NAFLD and mental disorders share pathophysiological pathways, and also present a complex, bidirectional relationship with the metabolic syndrome (MetS) and related cardiometabolic diseases.

Main text

This review compares the demographic data on NAFLD and NASH among the global population and the psychiatric population, finding differences that suggest a higher incidence of this disease among the latter. It also analyzes the link between NAFLD and psychiatric disorders, looking into common pathophysiological pathways, such as metabolic, genetic, and lifestyle factors. Finally, possible treatments, tailored approaches, and future research directions are suggested.

Conclusion

NAFLD is part of a complex system of mental and non-communicable somatic disorders with a common pathogenesis, based on shared lifestyle and environmental risks, mediated by dysregulation of inflammation, oxidative stress pathways, and mitochondrial function. The recognition of the prevalent comorbidity between NAFLD and mental disorders is required to inform clinical practice and develop novel interventions to prevent and treat these complex and interacting disorders.
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Metadata
Title
Non-alcoholic fatty liver disease (NAFLD) as a neglected metabolic companion of psychiatric disorders: common pathways and future approaches
Authors
Óscar Soto-Angona
Gerard Anmella
María José Valdés-Florido
Nieves De Uribe-Viloria
Andre F. Carvalho
Brenda W. J. H. Penninx
Michael Berk
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Fatty Liver
Published in
BMC Medicine / Issue 1/2020
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-020-01713-8

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