From NAFLD to NASH: Understanding the spectrum of non-alcoholic liver diseases and their consequences

Ahmed M Samy; Mohamed A Kandeil; Dina Sabry; A A Abdel-Ghany; Mohamed O Mahmoud

doi:10.1016/j.heliyon.2024.e30387

From NAFLD to NASH: Understanding the spectrum of non-alcoholic liver diseases and their consequences

Heliyon. 2024 Apr 25;10(9):e30387. doi: 10.1016/j.heliyon.2024.e30387. eCollection 2024 May 15.

Authors

Ahmed M Samy¹, Mohamed A Kandeil², Dina Sabry^{3

4}, A A Abdel-Ghany^{1

5}, Mohamed O Mahmoud⁶

Affiliations

¹ Department of Biochemistry, Faculty of Pharmacy, Nahda University, Beni-Suef 62513, Egypt.
² Department of Biochemistry, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef 62511, Egypt.
³ Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt.
⁴ Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Badr University in Cairo, Cairo 11829, Egypt.
⁵ Department of Biochemistry, Faculty of Pharmacy, Al-Azhar University, Assuit Branch, Egypt.
⁶ Department of Biochemistry, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62514, Egypt.

Abstract

Non-alcoholic fatty liver disease (NAFLD) has become one of the most frequent chronic liver diseases worldwide in recent decades. Metabolic diseases like excessive blood glucose, central obesity, dyslipidemia, hypertension, and liver function abnormalities cause NAFLD. NAFLD significantly increases the likelihood of liver cancer, heart disease, and mortality, making it a leading cause of liver transplants. Non-alcoholic steatohepatitis (NASH) is a more advanced form of the disease that causes scarring and inflammation of the liver over time and can ultimately result in cirrhosis and hepatocellular carcinoma. In this review, we briefly discuss NAFLD's pathogenic mechanisms, their progression into NASH and afterward to NASH-related cirrhosis. It also covers disease epidemiology, metabolic mechanisms, glucose and lipid metabolism in the liver, macrophage dysfunction, bile acid toxicity, and liver stellate cell stimulation. Additionally, we consider the contribution of intestinal microbiota, genetics, epigenetics, and ecological factors to fibrosis progression and hepatocellular carcinoma risk in NAFLD and NASH patients.

Keywords: Cirrhosis; Gut microbiota; Metabolic disorders; NAFLD; NASH.

Publication types

Review