Nonalcoholic fatty liver disease and cardiovascular concerns: The time for hepatologist and cardiologist close collaboration

Figure 1 Schematic figure depicting potential pathways for increased risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. Down arrows indicate decreased levels, and up arrows indicate increased levels. ADMA: Asymmetric dimethylarginine; CCL3: Chemokine (C-C motif) ligand 3; CVD: Cardiovascular disease; HDL-C: High-density lipoprotein cholesterol; hsCRP: High sensitivity C-reactive protein; HSD17B13: Hydroxysteroid 17 beta-13; IDL: Intermediate-density lipoprotein; IL1b: Interleukin 1b; IL6: Interleukin 6; LDL: Low-density lipoprotein; LDL-P: Low-density lipoprotein particles; M1/M2: Macrophage phenotype 1/2 ratio; MAMP: Microbe-associated molecular pattern; MARC1: Mitochondrial amidoxime-reducing component 1; NAFLD: Nonalcoholic fatty liver disease; PNPLA3: Patatin-like phospholipase domain-containing protein 3; SCFA: Short-chain fatty acids; sdLDL: Small dense low-density lipoprotein; sICAM1: Soluble intracellular adhesion molecule 1; TM6SF: Transmembrane 6 superfamily 2 human gene; TMA: Trimethylamine; TNF-α: Tumor necrosis factor-α; VEGF: VASCULAR endothelial growth factor; VLDL: Very-low-density lipoprotein.

Figure 2 Nonalcoholic fatty liver disease is strongly associated with an increased risk of cardiovascular disease comorbidities. ASCVD: Atherosclerotic cardiovascular disease; NAFLD: Nonalcoholic fatty liver disease.

Figure 3 Proposed algorithm for the screening of cardiovascular disease in patients with nonalcoholic fatty liver disease. CVD: Cardiovascular disease; CT: Computed tomography; DSE: Dobutamine stress echo; NAFLD: Nonalcoholic fatty liver disease.