Abstract
Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of progressive liver
disease encompassing simple steatosis, nonalcoholic steatohepatitis (NASH), fibrosis,
and, ultimately, cirrhosis. NAFLD is strongly associated with features of the metabolic
syndrome including abdominal overweight/obesity, hypertension, atherogenic dyslipidemia,
glucose intolerance, or type 2 diabetes. With the advent of increasingly sedentary
lifestyles and changing dietary patterns, the prevalence of obesity and insulin resistance
has increased and, with this, NAFLD has rapidly become the most common cause of chronic
liver disease in many developed countries. Importantly, accumulating evidence indicates
that NAFLD is strongly associated with a prothrombotic tendency, which may, at least
in part, contribute to the increased risk of atherothrombotic events observed in these
patients. NAFLD, especially in its necroinflammatory form (NASH), releases a variety
of proinflammatory and prothrombotic mediators that play important roles in the development
and progression of acute atherothrombotic complications. NAFLD also exacerbates systemic
and hepatic insulin resistance and causes atherogenic dyslipidemia. The purpose of
this review is to briefly discuss the epidemiology and diagnosis of NAFLD, to summarize
the rapidly expanding body of evidence that supports a strong association between
NAFLD and various disorders of coagulation and fibrinolysis and their implications
for the development of atherothrombotic complications, and to discuss some of the
treatment options that may influence both NAFLD and its related vascular complications.
Keywords
nonalcoholic fatty liver disease - atherothrombosis - blood coagulation disorders
- hemostatic factors - inflammation
