Metabolic and nutritional aspects of non-alcoholic fatty liver disease

Abstract

Currently, in the structure of liver pathology, the leading position is occupied by non-alcoholic fatty liver disease (NAFLD), ahead of viral hepatitis C and alcoholic liver disease. The previous concept of NAFLD as a harmless disease has undergone significant changes. In the modern understanding, non-alcoholic fatty liver disease is a progressive disease with a high risk of developing fibrosis, cirrhosis of the liver and hepatocellular carcinoma. The number of liver transplants in patients with cirrhosis as a result of NAFLD is steadily increasing and ranks second after cirrhosis of the liver of viral etiology. Nevertheless, non-alcoholic fatty liver disease is still considered a «diagnosis of exclusion» due to the lack of specific diagnostic criteria, and the term itself has been criticized since it focuses only on the absence of alcohol’s contribution to the development of the disease. For this reason, an international expert consensus statement was published in 2020, proposing a new concept – metabolically associated fatty liver disease (MAFLD), highlighting the leading role of nutritional metabolic predictors in the development of disease. We performed a systematic review to summarize the clinical nutritional aspects of MAFLD. The authors discuss the fundamental clinical and functional, nutritional, metabolic, hormonal, microbiotic factors of the pathological process that determine the course and prognosis of the disease. Information on the topic was used from publications based on the disserCat, PubMed, and eLibrary databases.

Keywords

• non-alcoholic fatty liver disease
• metabolically associated fatty liver disease
• microbiocenosis
• nutritional
• metabolic factors