Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2024; 16(7): 380-384
Published online Jul 26, 2024. doi: 10.4330/wjc.v16.i7.380
Excess cardiovascular mortality in men with non-alcoholic fatty liver disease: A cause for concern!
Akash Batta, Juniali Hatwal
Akash Batta, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Juniali Hatwal, Department of Internal Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, India
Author contributions: Batta A and Hatwal J contributed equally to the manuscript; Batta A and Hatwal J wrote the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akash Batta, MD, Assistant Professor, Senior Scientist, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India. akashbatta02@gmail.com
Received: April 21, 2024
Revised: May 25, 2024
Accepted: June 17, 2024
Published online: July 26, 2024
Processing time: 93 Days and 23.2 Hours
Abstract

Non-alcoholic fatty liver disease (NAFLD) has emerged as the commonest cause of chronic liver disease worldwide in recent years. With time, our understanding of NAFLD has evolved from an isolated liver condition to a systemic disease with significant manifestations beyond the liver. Amongst them, cardiovascular diseases (CVDs) are the most important and clinically relevant. Recent research supports a strong independent link between NALFD and CVD beyond the shared risk factors and pathophysiology. Female sex hormones are well known to not only protect against CVD in pre-menopausal females, but also contribute to improved adipose tissue function and preventing its systemic deposition. Recent research highlights the increased risk of major adverse cardiovascular-cerebral events (MACCE) amongst male with NAFLD compared to females. Further, racial variation was observed in MACCE outcomes in NAFLD, with excess mortality in the Native Americans and Asian Pacific Islanders compared to the other races.

Keywords: Non-alcoholic fatty liver disease; Cardiovascular diseases; Male sex; Major adverse cardiovascular-cerebral events; Inflammation; Endothelial dysfunction

Core Tip: Non-alcoholic fatty liver disease (NAFLD) has emerged as the commonest cause of chronic liver disease worldwide in recent years. In recent years, our understanding of NAFLD has evolved from an isolated liver condition to a systemic disease with significant manifestations beyond the liver. Amongst them, cardiovascular diseases (CVDs) are the most important and clinically relevant. Recent research supports a strong independent link between NALFD and CVD beyond the shared risk factors and pathophysiology. The findings from translational research and recent clinical data support the heightened risk of major adverse cardiovascular-cerebral events (MACCE) amongst male with NAFLD compared to females. Further, there was racial variation in MACCE outcomes in NAFLD, with excess mortality in the Native Americans and Asian Pacific Islanders compared to the other races largely attributable to the increased comorbidity burden and unfavorable genetics.