Lipids, liver and pancreas at the crossroads of metabolic syndrome and obesity epidemics

Abstract

The prevalence of metabolic syndrome (MS), non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty pancreatic disease (NAFPD) is 1/4–1/3 of the planet population. It has been proven that the main links in their pathogenesis are disorders of lipid and carbohydrate metabolism. A high comorbidity of NAFLD and NAFPD was shown: in 67,9 % of patients with NAFPD, fatty liver was revealed, and in 96,8 % of patients with NAFLD, pancreatic steatosis was diagnosed. The prevalence of MC among NAFPD patients is 59,2–76,9 %. A meta-analysis revealed that NAFPD is associated with an increased risk of MS (relative risk (RR) = 2,25; 95 % CI 2,00–2,53; p < 0,0001), arterial hypertension (RR = 1,43; 95 % CI 1,08–1,90; p = 0,013), NAFLD (RR = 2,49; 95 % CI 2,06–3,02; p < 0,0001), diabetes mellitus 2 type (RR = 1,99; 95 % CI 1,18–3,35; p = 0,01), and obesity (RR = 1,91; 95 % CI 1,67–2,19; p < 0,0001). Concomitant MS negatively affects the clinical course of acute and chronic pancreatitis, for example, moderately severe acute pancreatitis is observed 3 times more often with MS than without MS, partly due to that I, IV and V types of hyperlipidemia are associated with acute pancreatitis. Dyslipidemia in NAFLD occurs in 60–70 % of cases and is characterized by hypertriglyceridemia, elevated level of free fatty acids and low density lipoprotein cholesterol, decreased content of high density lipoprotein cholesterol. Therefore, strategies aimed at the primary prevention of dyslipidemia can help reduce morbidity and mortality in liver and pancreatic pathology associated with MS.

Keywords

• metabolic syndrome
• non-alcoholic fatty pancreatic disease
• non-alcoholic fatty liver disease
• acute pancreatitis
• chronic pancreatitis
• blood lipids