From liver to limb: Exploring the association between fatty liver disease and peripheral artery disease-A systematic review.

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Vera Ciornolutchii, Abdulrahman Ismaiel, Jennifer Bogdan, Stefan-Lucian Popa, Teodora Surdea-Blaga, Dan L Dumitrascu
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Abstract

Introduction: Fatty liver disease, encompassing nonalcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated fatty liver disease (MAFLD), and the recently redefined metabolic dysfunction-associated steatotic liver disease (MASLD), is a growing global health concern with significant cardiovascular implications. Peripheral artery disease (PAD), a common manifestation of systemic atherosclerosis, shares key pathophysiological mechanisms with fatty liver disease, including insulin resistance, systemic inflammation and endothelial dysfunction. Although emerging evidence suggests a link between fatty liver disease and PAD, the nature and extent of this association remain unclear. This systematic review synthesizes current research evaluating the relationship between fatty liver disease and PAD.

Methods: A systematic search of PubMed, Embase and Scopus was conducted up to December 19, 2024, following PRISMA 2020 guidelines. Eligible observational studies assessing PAD in MASLD, MAFLD or NAFLD patients were included. Quality assessment was performed independently by two reviewers using the Newcastle-Ottawa Scale (NOS).

Results: Eleven observational studies, including approximately 848,027 participants, were analysed. Most studies reported a significant association between NAFLD or MAFLD and increased PAD risk, particularly in individuals with type 2 diabetes and metabolic syndrome. Studies using MAFLD criteria demonstrated a stronger association with PAD than those using NAFLD definitions. The presence of hepatic fibrosis was linked to a higher PAD risk in some studies. However, not all studies found a consistent relationship, and a few reported no independent association between fatty liver disease and PAD, highlighting the need for further research. Notably, none of the included studies used MASLD criteria.

Conclusions: Patients with NAFLD or MAFLD, particularly those with metabolic comorbidities, may have an elevated risk of PAD. The severity of liver disease, including fibrosis, appears to contribute to this risk. Future studies should incorporate MASLD definitions and advanced diagnostic methods to clarify this relationship and guide clinical strategies for integrated cardiovascular and liver disease management.

从肝脏到肢体:探讨脂肪肝与外周动脉疾病的关系——系统综述。
简介:脂肪性肝病,包括非酒精性脂肪性肝病(NAFLD)、代谢功能障碍相关脂肪性肝病(MAFLD)和最近重新定义的代谢功能障碍相关脂肪性肝病(MASLD),是一个日益增长的全球健康问题,具有重要的心血管影响。外周动脉疾病(PAD)是全身性动脉粥样硬化的一种常见表现,与脂肪肝有共同的关键病理生理机制,包括胰岛素抵抗、全身炎症和内皮功能障碍。尽管新出现的证据表明脂肪性肝病与PAD之间存在联系,但这种联系的性质和程度仍不清楚。本系统综述综合了目前评价脂肪肝与PAD之间关系的研究。方法:根据PRISMA 2020指南,系统检索PubMed、Embase和Scopus,检索截止到2024年12月19日。纳入了评估MASLD、MAFLD或NAFLD患者PAD的合格观察性研究。质量评估由两名评论者使用纽卡斯尔-渥太华量表(NOS)独立进行。结果:分析了11项观察性研究,包括大约848,027名参与者。大多数研究报告了NAFLD或MAFLD与PAD风险增加之间的显著关联,特别是在2型糖尿病和代谢综合征患者中。使用NAFLD标准的研究表明,与使用NAFLD定义的研究相比,使用MAFLD标准的研究与PAD的相关性更强。在一些研究中,肝纤维化的存在与更高的PAD风险有关。然而,并不是所有的研究都发现了一致的关系,少数研究报告脂肪性肝病和PAD之间没有独立的关联,这突出了进一步研究的必要性。值得注意的是,纳入的研究中没有一个使用MASLD标准。结论:NAFLD或MAFLD患者,特别是伴有代谢合并症的患者,患PAD的风险可能升高。包括肝纤维化在内的肝脏疾病的严重程度似乎会导致这种风险。未来的研究应纳入MASLD的定义和先进的诊断方法,以澄清这种关系,并指导心血管和肝脏疾病综合管理的临床策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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