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Vol 75, No 3 (2024)
Review paper
Published online: 2024-06-26

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Metabolic-associated fatty liver disease and the role of hormones in its aetiopathogenesis

Szymon Suwała1, Roman Junik1
DOI: 10.5603/ep.99689
Pubmed: 38923899
Endokrynol Pol 2024;75(3):237-252.

Abstract

Metabolic-associated fatty liver disease (MAFLD) is a newly coined term that links the presence of liver steatosis (characterised by the accumulation of lipids in at least 5% of liver cells) with a condition of overall systemic metabolic dysfunction. MAFLD impacts 24–36% of the global population. As per the official guidelines, a diagnosis of MAFLD can be made when hepatosteatosis is accompanied by type 2 diabetes mellitus, overweight, obesity, or at least 2 other specific metabolic abnormalities (increased waist circumference, hypertension, dyslipidaemia, prediabetes, elevated C-reactive protein level, or increased homeostasis model assessment of insulin resistance: HOMA-IR).

MAFLD is a heterogeneous illness associated with multiple diseases that impact various organs, particularly endocrine organs. Endocrinopathies can significantly influence the progression and severity of MAFLD. This paper provides a brief overview of the existing research on the connection between liver steatosis and the functioning of endocrine organs. The authors also propose dividing endocrine diseases into those having a possible, strong, and clear relationship with hepatosteatosis (for the purpose of preliminary recommendations regarding the need for monitoring the possible progression of MAFLD in these groups of patients).

Keywords: metabolic-associated fatty liver diseaseliverobesitydiabetesMAFLDNAFLD

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References

  1. Eslam M, Newsome PN, Sarin SK, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020; 73(1): 202–209.
    CrossRefPubMed
  2. Dobrowolski P, Prejbisz A, Kuryłowicz A, et al. Metabolic syndrome - a new definition and management guidelines: A joint position paper by the Polish Society of Hypertension, Polish Society for the Treatment of Obesity, Polish Lipid Association, Polish Association for Study of Liver, Polish Society of Family Medicine, Polish Society of Lifestyle Medicine, Division of Prevention and Epidemiology Polish Cardiac Society, "Club 30" Polish Cardiac Society, and Division of Metabolic and Bariatric Surgery Society of Polish Surgeons. Arch Med Sci. 2022; 18(5): 1133–1156.
    CrossRefPubMed
  3. Shiha G, Korenjak M, Eskridge W, et al. Redefining fatty liver disease: an international patient perspective. Lancet Gastroenterol Hepatol. 2021; 6(1): 73–79.
    CrossRefPubMed
  4. Mantovani A. MAFLD vs NAFLD: Where are we? Dig Liver Dis. 2021; 53(10): 1368–1372.
    CrossRefPubMed
  5. Michaelidou M, Pappachan JM, Jeeyavudeen MS. Management of diabesity: Current concepts. World J Diabetes. 2023; 14(4): 396–411.
    CrossRefPubMed
  6. Suwała S, Białczyk A, Koperska K, et al. Prevalence and Crucial Parameters in Diabesity-Related Liver Fibrosis: A Preliminary Study. J Clin Med. 2023; 12(24).
    CrossRefPubMed
  7. Yamamura S, Eslam M, Kawaguchi T, et al. MAFLD identifies patients with significant hepatic fibrosis better than NAFLD. Liver Int. 2020; 40(12): 3018–3030.
    CrossRefPubMed
  8. Kim SH, Park MJ. Effects of growth hormone on glucose metabolism and insulin resistance in human. Ann Pediatr Endocrinol Metab. 2017; 22(3): 145–152.
    CrossRefPubMed
  9. Hutchison AL, Tavaglione F, Romeo S, et al. Endocrine aspects of metabolic dysfunction-associated steatotic liver disease (MASLD): Beyond insulin resistance. J Hepatol. 2023; 79(6): 1524–1541.
    CrossRefPubMed
  10. Lewiński A, Smyczyńska J, Stawerska R, et al. National Program of Severe Growth Hormone Deficiency Treatment in Adults and Adolescents after Completion of Growth Promoting Therapy. Endokrynol Pol. 2018; 69(5): 468–524.
    CrossRefPubMed
  11. Adams LA, Feldstein A, Lindor KD, et al. Nonalcoholic fatty liver disease among patients with hypothalamic and pituitary dysfunction. Hepatology. 2004; 39(4): 909–914.
    CrossRefPubMed
  12. Hong JW, Kim JY, Kim YE, et al. Metabolic parameters and nonalcoholic fatty liver disease in hypopituitary men. Horm Metab Res. 2011; 43(1): 48–54.
    CrossRefPubMed
  13. Xu L, Xu C, Yu C, et al. Association between serum growth hormone levels and nonalcoholic fatty liver disease: a cross-sectional study. PLoS One. 2012; 7(8): e44136.
    CrossRefPubMed
  14. Mosca A, Della Volpe L, Alisi A, et al. The Role of the GH/IGF1 Axis on the Development of MAFLD in Pediatric Patients with Obesity. Metabolites. 2022; 12(12).
    CrossRefPubMed
  15. Takahashi Y, Iida K, Takahashi K, et al. Growth hormone reverses nonalcoholic steatohepatitis in a patient with adult growth hormone deficiency. Gastroenterology. 2007; 132(3): 938–943.
    CrossRefPubMed
  16. Nishizawa H, Iguchi G, Murawaki A, et al. Nonalcoholic fatty liver disease in adult hypopituitary patients with GH deficiency and the impact of GH replacement therapy. Eur J Endocrinol. 2012; 167(1): 67–74.
    CrossRefPubMed
  17. Stanley TL, Fourman LT, Feldpausch MN, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV. 2019; 6(12): e821–e830.
    CrossRefPubMed
  18. Pan CS, Weiss JJ, Fourman LT, et al. Effect of recombinant human growth hormone on liver fat content in young adults with nonalcoholic fatty liver disease. Clin Endocrinol (Oxf). 2021; 94(2): 183–192.
    CrossRefPubMed
  19. Bettini S, Bombonato G, Dassie F, et al. Liver Fibrosis and Steatosis in Alström Syndrome: A Genetic Model for Metabolic Syndrome. Diagnostics (Basel). 2021; 11(5).
    CrossRefPubMed
  20. Fan Y, Fang X, Tajima A, et al. Evolution of hepatic steatosis to fibrosis and adenoma formation in liver-specific growth hormone receptor knockout mice. Front Endocrinol (Lausanne). 2014; 5: 218.
    CrossRefPubMed
  21. Rufinatscha K, Ress C, Folie S, et al. Metabolic effects of reduced growth hormone action in fatty liver disease. Hepatol Int. 2018; 12(5): 474–481.
    CrossRefPubMed
  22. Fellinger P, Wolf P, Pfleger L, et al. Increased ATP synthesis might counteract hepatic lipid accumulation in acromegaly. JCI Insight. 2020; 5(5).
    CrossRefPubMed
  23. Møller N, Jørgensen JO. Effects of growth hormone on glucose, lipid, and protein metabolism in human subjects. Endocr Rev. 2009; 30(2): 152–177.
    CrossRefPubMed
  24. Rogowicz-Frontczak A, Majchrzak A, Zozulińska-Ziółkiewicz D. Insulin resistance in endocrine disorders - treatment options. Endokrynol Pol. 2017; 68(3): 334–351.
    CrossRefPubMed
  25. Winhofer Y, Wolf P, Krššák M, et al. No evidence of ectopic lipid accumulation in the pathophysiology of the acromegalic cardiomyopathy. J Clin Endocrinol Metab. 2014; 99(11): 4299–4306.
    CrossRefPubMed
  26. Bredella MA, Schorr M, Dichtel LE, et al. Body Composition and Ectopic Lipid Changes With Biochemical Control of Acromegaly. J Clin Endocrinol Metab. 2017; 102(11): 4218–4225.
    CrossRefPubMed
  27. Arlien-Søborg MC, Madsen MA, Dal J, et al. Ectopic lipid deposition and insulin resistance in patients with GH disorders before and after treatment. Eur J Endocrinol. 2023; 188(1).
    CrossRefPubMed
  28. Ciresi A, Guarnotta V, Campo D, et al. Hepatic Steatosis Index in Acromegaly: Correlation with Insulin Resistance Regardless of the Disease Control. Int J Endocrinol. 2018; 2018: 5421961.
    CrossRefPubMed
  29. Eroğlu İ, Iremli BG, Idilman IS, et al. Nonalcoholic Fatty Liver Disease, Liver Fibrosis, and Utility of Noninvasive Scores in Patients With Acromegaly. J Clin Endocrinol Metab. 2023; 109(1): e119–e129.
    CrossRefPubMed
  30. Gierach M, Bruska-Sikorska M, Rojek M, et al. Hyperprolactinemia and insulin resistance. Endokrynol Pol. 2022; 73(6): 959–967.
    CrossRefPubMed
  31. Zhang P, Ge Z, Wang H, et al. Prolactin improves hepatic steatosis via CD36 pathway. J Hepatol. 2018; 68(6): 1247–1255.
    CrossRefPubMed
  32. Luque GM, Lopez-Vicchi F, Ornstein AM, et al. Chronic hyperprolactinemia evoked by disruption of lactotrope dopamine D2 receptors impacts on liver and adipocyte genes related to glucose and insulin balance. Am J Physiol Endocrinol Metab. 2016; 311(6): E974–E988.
    CrossRefPubMed
  33. Takaki Y, Mizuochi T, Nishioka J, et al. Nonalcoholic fatty liver disease with prolactin-secreting pituitary adenoma in an adolescent: A case report. Medicine (Baltimore). 2018; 97(42): e12879.
    CrossRefPubMed
  34. Zhu C, Ma H, Huang D, et al. J-Shaped Relationship Between Serum Prolactin and Metabolic-Associated Fatty Liver Disease in Female Patients With Type 2 Diabetes. Front Endocrinol (Lausanne). 2022; 13: 815995.
    CrossRefPubMed
  35. Zhang Y, Liu H. Cross-sectional association between prolactin levels and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus: a retrospective analysis of patients from a single hospital in China. BMJ Open. 2022; 12(10): e062252.
    CrossRefPubMed
  36. Szmygin H, Szydełko J, Matyjaszek-Matuszek B. Copeptin as a novel biomarker of cardiometabolic syndrome. Endokrynol Pol. 2021; 72(5): 566–571.
    CrossRefPubMed
  37. Barchetta I, Enhörning S, Cimini FA, et al. Elevated plasma copeptin levels identify the presence and severity of non-alcoholic fatty liver disease in obesity. BMC Med. 2019; 17(1): 85.
    CrossRefPubMed
  38. Gomaa R. Copeptin: a novel marker for diagnosis and prognosisof various diseases associated with diabetes. BOHR Int J Gen Int Med. 2022; 1(1): 46–50.
    CrossRef
  39. Nashaat E, Riad G, Ghait R, et al. Elevated Plasma Copeptin Levels Identify the Presence and Severity of Nonalcoholic Fatty Liver Disease in Obesity. QJM: Int J Med. 2023; 116(Suppl_1).
    CrossRef
  40. Majumdar S, Thakur MB, Ran A. Comparative Evaluation of Serum Copeptin in Obesity with Non Alcoholic Fatty Liver Disease. J Assoc Physicians India. 2023; 71(1): 1.
    PubMed
  41. Rofe AM, Williamson DH. Metabolic effects of vasopressin infusion in the starved rat. Reversal of ketonaemia. Biochem J. 1983; 212(1): 231–239.
    CrossRefPubMed
  42. Xue B, Moustaid‐Moussa N, Wilkison W, et al. The agouti gene product inhibits lipolysis in human adipocytes via a Ca2+‐dependent mechanism. FASEB J. 1998; 12(13): 1391–1396.
    CrossRef
  43. Hiroyama M, Aoyagi T, Fujiwara Y, et al. Hypermetabolism of fat in V1a vasopressin receptor knockout mice. Mol Endocrinol. 2007; 21(1): 247–258.
    CrossRefPubMed
  44. Bambini F, Gatta E, D'Alessio R, et al. Thyroid disease and autoimmunity in obese patients: a narrative review. Endokrynol Pol. 2023; 74(6).
    CrossRefPubMed
  45. Bikeyeva V, Abdullah A, Radivojevic A, et al. Nonalcoholic Fatty Liver Disease and Hypothyroidism: What You Need to Know. Cureus. 2022; 14(8): e28052.
    CrossRefPubMed
  46. Bano A, Chaker L, Plompen EPC, et al. Thyroid Function and the Risk of Nonalcoholic Fatty Liver Disease: The Rotterdam Study. J Clin Endocrinol Metab. 2016; 101(8): 3204–3211.
    CrossRefPubMed
  47. He W, An X, Li L, et al. Relationship between Hypothyroidism and Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis. Front Endocrinol (Lausanne). 2017; 8: 335.
    CrossRefPubMed
  48. Mantovani A, Nascimbeni F, Lonardo A, et al. Association Between Primary Hypothyroidism and Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Thyroid. 2018; 28(10): 1270–1284.
    CrossRefPubMed
  49. Lonardo A, Ballestri S, Mantovani A, et al. Pathogenesis of hypothyroidism-induced NAFLD: Evidence for a distinct disease entity? Dig Liver Dis. 2019; 51(4): 462–470.
    CrossRefPubMed
  50. Mandato C, D'Acunzo I, Vajro P. Thyroid dysfunction and its role as a risk factor for non-alcoholic fatty liver disease: What's new. Dig Liver Dis. 2018; 50(11): 1163–1165.
    CrossRefPubMed
  51. Piantanida E, Ippolito S, Gallo D, et al. The interplay between thyroid and liver: implications for clinical practice. J Endocrinol Invest. 2020; 43(7): 885–899.
    CrossRefPubMed
  52. Xu C, Xu L, Yu C, et al. Association between thyroid function and nonalcoholic fatty liver disease in euthyroid elderly Chinese. Clin Endocrinol (Oxf). 2011; 75(2): 240–246.
    CrossRefPubMed
  53. Sinha RA, Bruinstroop E, Singh BK, et al. Nonalcoholic Fatty Liver Disease and Hypercholesterolemia: Roles of Thyroid Hormones, Metabolites, and Agonists. Thyroid. 2019; 29(9): 1173–1191.
    CrossRefPubMed
  54. Chen Yi, Wang N, Chen Y, et al. The association of non-alcoholic fatty liver disease with thyroid peroxidase and thyroglobulin antibody: A new insight from SPECT-China study. Autoimmunity. 2018; 51(5): 238–244.
    CrossRefPubMed
  55. Wang C, Niu Q, Lv H, et al. Elevated TPOAb is a Strong Predictor of Autoimmune Development in Patients of Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: A Case-Control Study. Diabetes Metab Syndr Obes. 2020; 13: 4369–4378.
    CrossRefPubMed
  56. Kim HJ, Park SJ, Park HK, et al. Association of thyroid autoimmunity with nonalcoholic fatty liver disease in euthyroid middle-aged subjects: A population-based study. J Gastroenterol Hepatol. 2022; 37(8): 1617–1623.
    CrossRefPubMed
  57. Zhang X, Li R, Chen Y, et al. The Role of Thyroid Hormones and Autoantibodies in Metabolic Dysfunction Associated Fatty Liver Disease: TgAb May Be a Potential Protective Factor. Front Endocrinol (Lausanne). 2020; 11: 598836.
    CrossRefPubMed
  58. Wang SH, Chen XY, Wang XP. Jidong Restless Legs Syndrome Cohort Study: Objectives, Design, and Baseline Screening. Front Neurol. 2021; 12: 682448.
    CrossRefPubMed
  59. Xiao R, Ni C, Cai Y, et al. Prevalence and impact of non-alcoholic fatty liver disease in patients with papillary thyroid carcinoma. Endocrine. 2023; 80(3): 619–629.
    CrossRefPubMed
  60. Liu S, Liu Y, Wan Bo, et al. Association between Vitamin D Status and Non-Alcoholic Fatty Liver Disease: A Population-Based Study. J Nutr Sci Vitaminol (Tokyo). 2019; 65(4): 303–308.
    CrossRefPubMed
  61. Sindhughosa DA, Wibawa ID, Mariadi IK, et al. Additional treatment of vitamin D for improvement of insulin resistance in non-alcoholic fatty liver disease patients: a systematic review and meta-analysis. Sci Rep. 2022; 12(1): 7716.
    CrossRefPubMed
  62. Kim Y, Chang Y, Ryu S, et al. Resolution of, and Risk of Incident Non-alcoholic Fatty Liver Disease With Changes in Serum 25-hydroxy Vitamin D Status. J Clin Endocrinol Metab. 2022; 107(8): e3437–e3447.
    CrossRefPubMed
  63. Dal K, Uzman M, Ata N, et al. The effect of vitamin D status on non-alcoholic fatty liver disease: a population-based observational study. Endokrynol Pol. 2023; 74(1): 63–66.
    CrossRefPubMed
  64. Abramovitch S, Dahan-Bachar L, Sharvit E, et al. Vitamin D inhibits proliferation and profibrotic marker expression in hepatic stellate cells and decreases thioacetamide-induced liver fibrosis in rats. Gut. 2011; 60(12): 1728–1737.
    CrossRefPubMed
  65. Beilfuss A, Sowa JP, Sydor S, et al. Vitamin D counteracts fibrogenic TGF-β signalling in human hepatic stellate cells both receptor-dependently and independently. Gut. 2015; 64(5): 791–799.
    CrossRefPubMed
  66. Farhangi MA, Mesgari-Abbasi M, Hajiluian G, et al. Adipose Tissue Inflammation and Oxidative Stress: the Ameliorative Effects of Vitamin D. Inflammation. 2017; 40(5): 1688–1697.
    CrossRefPubMed
  67. Abramovitch S, Sharvit E, Weisman Y, et al. Vitamin D inhibits development of liver fibrosis in an animal model but cannot ameliorate established cirrhosis. Am J Physiol Gastrointest Liver Physiol. 2015; 308(2): G112–G120.
    CrossRefPubMed
  68. Roth CL, Elfers CT, Figlewicz DP, et al. Vitamin D deficiency in obese rats exacerbates nonalcoholic fatty liver disease and increases hepatic resistin and Toll-like receptor activation. Hepatology. 2012; 55(4): 1103–1111.
    CrossRefPubMed
  69. Sarkar S. Molecular Crosstalk Between Vitamin D and Non-alcoholic Fatty Liver Disease. Explor Res Hypothesis Med. 2023; 9(1): 60–75.
    CrossRef
  70. Maestro B, Molero S, Bajo S, et al. Transcriptional activation of the human insulin receptor gene by 1,25-dihydroxyvitamin D(3). Cell Biochem Funct. 2002; 20(3): 227–232.
    CrossRefPubMed
  71. Shepherd PR, Withers DJ, Siddle K. Phosphoinositide 3-kinase: the key switch mechanism in insulin signalling. Biochem J. 1998; 333 ( Pt 3)(Pt 3): 471–490.
    CrossRefPubMed
  72. Copps KD, White MF. Regulation of insulin sensitivity by serine/threonine phosphorylation of insulin receptor substrate proteins IRS1 and IRS2. Diabetologia. 2012; 55(10): 2565–2582.
    CrossRefPubMed
  73. Wahsh E, Abu-Elsaad N, El-Karef A, et al. The vitamin D receptor agonist, calcipotriol, modulates fibrogenic pathways mitigating liver fibrosis in-vivo: An experimental study. Eur J Pharmacol. 2016; 789: 362–369.
    CrossRefPubMed
  74. Patel YA, Henao R, Moylan CA, et al. Vitamin D is Not Associated With Severity in NAFLD: Results of a Paired Clinical and Gene Expression Profile Analysis. Am J Gastroenterol. 2016; 111(11): 1591–1598.
    CrossRefPubMed
  75. Dabbaghmanesh MH, Danafar F, Eshraghian A, et al. Vitamin D supplementation for the treatment of non-alcoholic fatty liver disease: A randomized double blind placebo controlled trial. Diabetes Metab Syndr. 2018; 12(4): 513–517.
    CrossRefPubMed
  76. Wang N, Chen C, Zhao Li, et al. Vitamin D and Nonalcoholic Fatty Liver Disease: Bi-directional Mendelian Randomization Analysis. EBioMedicine. 2018; 28: 187–193.
    CrossRefPubMed
  77. Barry EL, Rees JR, Peacock JL, et al. Genetic variants in CYP2R1, CYP24A1, and VDR modify the efficacy of vitamin D3 supplementation for increasing serum 25-hydroxyvitamin D levels in a randomized controlled trial. J Clin Endocrinol Metab. 2014; 99(10): E2133–E2137.
    CrossRefPubMed
  78. Zhang M, Zhao LJ, Zhou Yu, et al. SNP rs11185644 of RXRA gene is identified for dose-response variability to vitamin D3 supplementation: a randomized clinical trial. Sci Rep. 2017; 7: 40593.
    CrossRefPubMed
  79. Al-Daghri NM, Mohammed AK, Al-Attas OS, et al. Vitamin D Receptor Gene Polymorphisms Modify Cardiometabolic Response to Vitamin D Supplementation in T2DM Patients. Sci Rep. 2017; 7(1): 8280.
    CrossRefPubMed
  80. Płudowski P, Kos-Kudła B, Walczak M, et al. Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland. Nutrients. 2023; 15(3).
    CrossRefPubMed
  81. Patel R, Williams-Dautovich J, Cummins CL. Minireview: new molecular mediators of glucocorticoid receptor activity in metabolic tissues. Mol Endocrinol. 2014; 28(7): 999–1011.
    CrossRefPubMed
  82. Papanastasiou L, Fountoulakis S, Vatalas IA. Adrenal disorders and non-alcoholic fatty liver disease. Minerva Endocrinol. 2017; 42(2): 151–163.
    CrossRefPubMed
  83. Zhou J, Zhang M, Bai X, et al. Demographic Characteristics, Etiology, and Comorbidities of Patients with Cushing's Syndrome: A 10-Year Retrospective Study at a Large General Hospital in China. Int J Endocrinol. 2019; 2019: 7159696.
    CrossRefPubMed
  84. Remon P, Gutierrez A, Moreno E, et al. MAFLD prevalence in a cohort of patients with Cushing's disease. Endocrine Abstracts. 2023.
    CrossRef
  85. Chen K, Chen L, Dai J, et al. MAFLD in Patients with Cushing's Disease Is Negatively Associated with Low Free Thyroxine Levels Rather than with Cortisol or TSH Levels. Int J Endocrinol. 2023; 2023: 6637396.
    CrossRefPubMed
  86. Targher G, Bertolini L, Padovani R, et al. Associations between liver histology and cortisol secretion in subjects with nonalcoholic fatty liver disease. Clin Endocrinol (Oxf). 2006; 64(3): 337–341.
    CrossRefPubMed
  87. Zoppini G, Targher G, Venturi C, et al. Relationship of nonalcoholic hepatic steatosis to overnight low-dose dexamethasone suppression test in obese individuals. Clin Endocrinol (Oxf). 2004; 61(6): 711–715.
    CrossRefPubMed
  88. Masuzaki H, Paterson J, Shinyama H, et al. A transgenic model of visceral obesity and the metabolic syndrome. Science. 2001; 294(5549): 2166–2170.
    CrossRefPubMed
  89. Morton NM, Holmes MC, Fiévet C, et al. Improved lipid and lipoprotein profile, hepatic insulin sensitivity, and glucose tolerance in 11beta-hydroxysteroid dehydrogenase type 1 null mice. J Biol Chem. 2001; 276(44): 41293–41300.
    CrossRefPubMed
  90. Morgan SA, McCabe EL, Gathercole LL, et al. 11β-HSD1 is the major regulator of the tissue-specific effects of circulating glucocorticoid excess. Proc Natl Acad Sci U S A. 2014; 111(24): E2482–E2491.
    CrossRefPubMed
  91. Stefan N, Ramsauer M, Jordan P, et al. Inhibition of 11β-HSD1 with RO5093151 for non-alcoholic fatty liver disease: a multicentre, randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2014; 2(5): 406–416.
    CrossRefPubMed
  92. Dowman JK, Hopkins LJ, Reynolds GM, et al. Loss of 5α-reductase type 1 accelerates the development of hepatic steatosis but protects against hepatocellular carcinoma in male mice. Endocrinology. 2013; 154(12): 4536–4547.
    CrossRefPubMed
  93. Livingstone DEW, Barat P, Di Rollo EM, et al. 5α-Reductase type 1 deficiency or inhibition predisposes to insulin resistance, hepatic steatosis, and liver fibrosis in rodents. Diabetes. 2015; 64(2): 447–458.
    CrossRefPubMed
  94. Ahmed A, Rabbitt E, Brady T, et al. A switch in hepatic cortisol metabolism across the spectrum of non alcoholic fatty liver disease. PLoS One. 2012; 7(2): e29531.
    CrossRefPubMed
  95. Bataller R, Sancho-Bru P, Ginès P, et al. Activated human hepatic stellate cells express the renin-angiotensin system and synthesize angiotensin II. Gastroenterology. 2003; 125(1): 117–125.
    CrossRefPubMed
  96. Li Y, Zhang Y, Chen T, et al. Role of aldosterone in the activation of primary mice hepatic stellate cell and liver fibrosis via NLRP3 inflammasome. J Gastroenterol Hepatol. 2020; 35(6): 1069–1077.
    CrossRefPubMed
  97. Hu J, Cai X, Zhu Q, et al. Relationship Between Plasma Aldosterone Concentrations and Non-Alcoholic Fatty Liver Disease Diagnosis in Patients with Hypertension: A Retrospective Cohort Study. Diabetes Metab Syndr Obes. 2023; 16: 1625–1636.
    CrossRefPubMed
  98. Wada T, Ohshima S, Fujisawa E, et al. Aldosterone inhibits insulin-induced glucose uptake by degradation of insulin receptor substrate (IRS) 1 and IRS2 via a reactive oxygen species-mediated pathway in 3T3-L1 adipocytes. Endocrinology. 2009; 150(4): 1662–1669.
    CrossRefPubMed
  99. Yamashita R, Kikuchi T, Mori Y, et al. Aldosterone stimulates gene expression of hepatic gluconeogenic enzymes through the glucocorticoid receptor in a manner independent of the protein kinase B cascade. Endocr J. 2004; 51(2): 243–251.
    CrossRefPubMed
  100. Kumar A, Blackshear C, Subauste JS, et al. Fatty Liver Disease, Women, and Aldosterone: Finding a Link in the Jackson Heart Study. J Endocr Soc. 2017; 1(5): 460–469.
    CrossRefPubMed
  101. Chen Yi, Chen X, Chen Q, et al. Non-Alcoholic Fatty Liver Disease and Hypokalemia in Primary Aldosteronism Among Chinese Population. Front Endocrinol (Lausanne). 2021; 12: 565714.
    CrossRefPubMed
  102. Fallo F, Dalla Pozza A, Tecchio M, et al. Nonalcoholic fatty liver disease in primary aldosteronism: a pilot study. Am J Hypertens. 2010; 23(1): 2–5.
    CrossRefPubMed
  103. Yokohama S, Yoneda M, Haneda M, et al. Therapeutic efficacy of an angiotensin II receptor antagonist in patients with nonalcoholic steatohepatitis. Hepatology. 2004; 40(5): 1222–1225.
    CrossRefPubMed
  104. Georgescu EF, Ionescu R, Niculescu M, et al. Angiotensin-receptor blockers as therapy for mild-to-moderate hypertension-associated non-alcoholic steatohepatitis. World J Gastroenterol. 2009; 15(8): 942–954.
    CrossRefPubMed
  105. Goh GB, Pagadala MR, Dasarathy J, et al. Renin-angiotensin system and fibrosis in non-alcoholic fatty liver disease. Liver Int. 2015; 35(3): 979–985.
    CrossRefPubMed
  106. Pizarro M, Solís N, Quintero P, et al. Beneficial effects of mineralocorticoid receptor blockade in experimental non-alcoholic steatohepatitis. Liver Int. 2015; 35(9): 2129–2138.
    CrossRefPubMed
  107. Perakakis N, Bornstein SR, Birkenfeld AL, et al. FIDELIO-DKD and FIGARO-DKD investigators. Efficacy of finerenone in patients with type 2 diabetes, chronic kidney disease and altered markers of liver steatosis and fibrosis: A FIDELITY subgroup analysis. Diabetes Obes Metab. 2024; 26(1): 191–200.
    CrossRefPubMed
  108. Hirata T, Tomita K, Kawai T, et al. Effect of Telmisartan or Losartan for Treatment of Nonalcoholic Fatty Liver Disease: Fatty Liver Protection Trial by Telmisartan or Losartan Study (FANTASY). Int J Endocrinol. 2013; 2013: 587140.
    CrossRefPubMed
  109. Kurtz TW. Treating the metabolic syndrome: telmisartan as a peroxisome proliferator-activated receptor-gamma activator. Acta Diabetol. 2005; 42 Suppl 1: S9–16.
    CrossRefPubMed
  110. Polyzos SA, Kountouras J, Zafeiriadou E, et al. Effect of spironolactone and vitamin E on serum metabolic parameters and insulin resistance in patients with nonalcoholic fatty liver disease. J Renin Angiotensin Aldosterone Syst. 2011; 12(4): 498–503.
    CrossRefPubMed
  111. Tchernof A, Labrie F. Dehydroepiandrosterone, obesity and cardiovascular disease risk: a review of human studies. Eur J Endocrinol. 2004; 151(1): 1–14.
    CrossRefPubMed
  112. Celebi F, Yilmaz I, Aksoy H, et al. Dehydroepiandrosterone prevents oxidative injury in obstructive jaundice in rats. J Int Med Res. 2004; 32(4): 400–405.
    CrossRefPubMed
  113. Iwasaki T, Mukasa K, Yoneda M, et al. Marked attenuation of production of collagen type I from cardiac fibroblasts by dehydroepiandrosterone. Am J Physiol Endocrinol Metab. 2005; 288(6): E1222–E1228.
    CrossRefPubMed
  114. Hildebrand F, Pape HC, Hoevel P, et al. The importance of systemic cytokines in the pathogenesis of polymicrobial sepsis and dehydroepiandrosterone treatment in a rodent model. Shock. 2003; 20(4): 338–346.
    CrossRefPubMed
  115. Yoneda M, Wada K, Katayama K, et al. A novel therapy for acute hepatitis utilizing dehydroepiandrosterone in the murine model of hepatitis. Biochem Pharmacol. 2004; 68(11): 2283–2289.
    CrossRefPubMed
  116. Apostolova G, Schweizer RAS, Balazs Z, et al. Dehydroepiandrosterone inhibits the amplification of glucocorticoid action in adipose tissue. Am J Physiol Endocrinol Metab. 2005; 288(5): E957–E964.
    CrossRefPubMed
  117. Tagawa N, Minamitani E, Yamaguchi Y, et al. Alternative mechanism for anti-obesity effect of dehydroepiandrosterone: possible contribution of 11β-hydroxysteroid dehydrogenase type 1 inhibition in rodent adipose tissue. Steroids. 2011; 76(14): 1546–1553.
    CrossRefPubMed
  118. Jakubowicz D, Beer N, Rengifo R. Effect of dehydroepiandrosterone on cyclic-guanosine monophosphate in men of advancing age. Ann N Y Acad Sci. 1995; 774: 312–315.
    CrossRefPubMed
  119. Charlton M, Angulo P, Chalasani N, et al. Low circulating levels of dehydroepiandrosterone in histologically advanced nonalcoholic fatty liver disease. Hepatology. 2008; 47(2): 484–492.
    CrossRefPubMed
  120. Sumida Y, Yonei Y, Kanemasa K, et al. Lower circulating levels of dehydroepiandrosterone, independent of insulin resistance, is an important determinant of severity of non-alcoholic steatohepatitis in Japanese patients. Hepatol Res. 2010; 40(9): 901–910.
    CrossRefPubMed
  121. Koehler E, Swain J, Sanderson S, et al. Growth hormone, dehydroepiandrosterone and adiponectin levels in non-alcoholic steatohepatitis: an endocrine signature for advanced fibrosis in obese patients. Liver Int. 2012; 32(2): 279–286.
    CrossRefPubMed
  122. Tokushige K, Hashimoto E, Kodama K, et al. Serum metabolomic profile and potential biomarkers for severity of fibrosis in nonalcoholic fatty liver disease. J Gastroenterol. 2013; 48(12): 1392–1400.
    CrossRefPubMed
  123. Völzke H, Aumann N, Krebs A, et al. Hepatic steatosis is associated with low serum testosterone and high serum DHEAS levels in men. Int J Androl. 2010; 33(1): 45–53.
    CrossRefPubMed
  124. Koga M, Saito H, Mukai M, et al. Serum dehydroepiandrosterone sulphate levels in patients with non-alcoholic fatty liver disease. Intern Med. 2011; 50(16): 1657–1661.
    CrossRefPubMed
  125. Wang WB, She F, Xie LF, et al. Evaluation of Basal Serum Adrenocorticotropic Hormone and Cortisol Levels and Their Relationship with Nonalcoholic Fatty Liver Disease in Male Patients with Idiopathic Hypogonadotropic Hypogonadism. Chin Med J (Engl). 2016; 129(10): 1147–1153.
    CrossRefPubMed
  126. Zhang X, Mou Y, Aribas E, et al. Associations of Sex Steroids and Sex Hormone-Binding Globulin with Non-Alcoholic Fatty Liver Disease: A Population-Based Study and Meta-Analysis. Genes (Basel). 2022; 13(6).
    CrossRefPubMed
  127. Licht CMM, Vreeburg SA, van Reedt Dortland AKB, et al. Increased sympathetic and decreased parasympathetic activity rather than changes in hypothalamic-pituitary-adrenal axis activity is associated with metabolic abnormalities. J Clin Endocrinol Metab. 2010; 95(5): 2458–2466.
    CrossRefPubMed
  128. Ghosh PM, Shu ZJ, Zhu B, et al. Role of β-adrenergic receptors in regulation of hepatic fat accumulation during aging. J Endocrinol. 2012; 213(3): 251–261.
    CrossRefPubMed
  129. Shi Y, Shu ZJ, Xue X, et al. β2-Adrenergic receptor ablation modulates hepatic lipid accumulation and glucose tolerance in aging mice. Exp Gerontol. 2016; 78: 32–38.
    CrossRefPubMed
  130. Bruinstroop E, Fliers E, Kalsbeek A. Restoring the autonomic balance to reduce liver steatosis. J Physiol. 2019; 597(18): 4683–4684.
    CrossRefPubMed
  131. Shi Y, Pizzini J, Wang H, et al. -Adrenergic receptor agonist induced hepatic steatosis in mice: modeling nonalcoholic fatty liver disease in hyperadrenergic states. Am J Physiol Endocrinol Metab. 2021; 321(1): E90–E9E104.
    CrossRefPubMed
  132. Lelou E, Corlu A, Nesseler N, et al. The Role of Catecholamines in Pathophysiological Liver Processes. Cells. 2022; 11(6).
    CrossRefPubMed
  133. Sigala B, McKee C, Soeda J, et al. Sympathetic nervous system catecholamines and neuropeptide Y neurotransmitters are upregulated in human NAFLD and modulate the fibrogenic function of hepatic stellate cells. PLoS One. 2013; 8(9): e72928.
    CrossRefPubMed
  134. Adori C, Daraio T, Kuiper R, et al. Disorganization and degeneration of liver sympathetic innervations in nonalcoholic fatty liver disease revealed by 3D imaging. Sci Adv. 2021; 7(30).
    CrossRefPubMed
  135. Zhang H, Liu Y, Wang Li, et al. Differential effects of estrogen/androgen on the prevention of nonalcoholic fatty liver disease in the male rat. J Lipid Res. 2013; 54(2): 345–357.
    CrossRefPubMed
  136. Hart-Unger S, Arao Y, Hamilton KJ, et al. Hormone signaling and fatty liver in females: analysis of estrogen receptor α mutant mice. Int J Obes (Lond). 2017; 41(6): 945–954.
    CrossRefPubMed
  137. Pal SC, Eslam M, Mendez-Sanchez N, et al. Detangling the interrelations between MAFLD, insulin resistance, and key hormones. Hormones (Athens). 2022; 21(4): 573–589.
    CrossRefPubMed
  138. Gutierrez-Grobe Y, Ponciano-Rodríguez G, Ramos MH, et al. Prevalence of non alcoholic fatty liver disease in premenopausal, posmenopausal and polycystic ovary syndrome women. The role of estrogens. Ann Hepatol. 2010; 9(4): 402–409.
    PubMed
  139. Klair JS, Yang JuD, Abdelmalek MF, et al. Nonalcoholic Steatohepatitis Clinical Research Network. A longer duration of estrogen deficiency increases fibrosis risk among postmenopausal women with nonalcoholic fatty liver disease. Hepatology. 2016; 64(1): 85–91.
    CrossRefPubMed
  140. Von-Hafe M, Borges-Canha M, Vale C, et al. Nonalcoholic Fatty Liver Disease and Endocrine Axes-A Scoping Review. Metabolites. 2022; 12(4).
    CrossRefPubMed
  141. Zhu L, Brown WC, Cai Q, et al. Estrogen treatment after ovariectomy protects against fatty liver and may improve pathway-selective insulin resistance. Diabetes. 2013; 62(2): 424–434.
    CrossRefPubMed
  142. D'Eon TM, Souza SC, Aronovitz M, et al. Estrogen regulation of adiposity and fuel partitioning. Evidence of genomic and non-genomic regulation of lipogenic and oxidative pathways. J Biol Chem. 2005; 280(43): 35983–35991.
    CrossRefPubMed
  143. Camporez JP, Jornayvaz FR, Lee HY, et al. Cellular mechanism by which estradiol protects female ovariectomized mice from high-fat diet-induced hepatic and muscle insulin resistance. Endocrinology. 2013; 154(3): 1021–1028.
    CrossRefPubMed
  144. Matsuo K, Gualtieri MR, Cahoon SS, et al. Surgical menopause and increased risk of nonalcoholic fatty liver disease in endometrial cancer. Menopause. 2016; 23(2): 189–196.
    CrossRefPubMed
  145. Florio AA, Graubard BI, Yang B, et al. Oophorectomy and risk of non-alcoholic fatty liver disease and primary liver cancer in the Clinical Practice Research Datalink. Eur J Epidemiol. 2019; 34(9): 871–878.
    CrossRefPubMed
  146. Yang JuD, Abdelmalek MF, Guy CD, et al. Nonalcoholic Steatohepatitis Clinical Research Network. Patient Sex, Reproductive Status, and Synthetic Hormone Use Associate With Histologic Severity of Nonalcoholic Steatohepatitis. Clin Gastroenterol Hepatol. 2017; 15(1): 127–131.e2.
    CrossRefPubMed
  147. Nguyen MC, Stewart RB, Banerji MA, et al. Relationships between tamoxifen use, liver fat and body fat distribution in women with breast cancer. Int J Obes Relat Metab Disord. 2001; 25(2): 296–298.
    CrossRefPubMed
  148. Yang YJ, Kim KMo, An JiH, et al. Clinical significance of fatty liver disease induced by tamoxifen and toremifene in breast cancer patients. Breast. 2016; 28: 67–72.
    CrossRefPubMed
  149. Hong N, Yoon HG, Seo DaH, et al. Different patterns in the risk of newly developed fatty liver and lipid changes with tamoxifen versus aromatase inhibitors in postmenopausal women with early breast cancer: A propensity score-matched cohort study. Eur J Cancer. 2017; 82: 103–114.
    CrossRefPubMed
  150. Yoo JJ, Lim YS, Kim MS, et al. Risk of fatty liver after long-term use of tamoxifen in patients with breast cancer. PLoS One. 2020; 15(7): e0236506.
    CrossRefPubMed
  151. Bruno S, Maisonneuve P, Castellana P, et al. Incidence and risk factors for non-alcoholic steatohepatitis: prospective study of 5408 women enrolled in Italian tamoxifen chemoprevention trial. BMJ. 2005; 330(7497): 932.
    CrossRefPubMed
  152. Saphner T, Triest-Robertson S, Li H, et al. The association of nonalcoholic steatohepatitis and tamoxifen in patients with breast cancer. Cancer. 2009; 115(14): 3189–3195.
    CrossRefPubMed
  153. Jones H, Sprung VS, Pugh CJA, et al. Polycystic ovary syndrome with hyperandrogenism is characterized by an increased risk of hepatic steatosis compared to nonhyperandrogenic PCOS phenotypes and healthy controls, independent of obesity and insulin resistance. J Clin Endocrinol Metab. 2012; 97(10): 3709–3716.
    CrossRefPubMed
  154. Kelley CE, Brown AJ, Diehl AM, et al. Review of nonalcoholic fatty liver disease in women with polycystic ovary syndrome. World J Gastroenterol. 2014; 20(39): 14172–14184.
    CrossRefPubMed
  155. Schiffer L, Kempegowda P, Arlt W, et al. MECHANISMS IN ENDOCRINOLOGY: The sexually dimorphic role of androgens in human metabolic disease. Eur J Endocrinol. 2017; 177(3): R125–R143.
    CrossRefPubMed
  156. Kumarendran B, O'Reilly MW, Manolopoulos KN, et al. Polycystic ovary syndrome, androgen excess, and the risk of nonalcoholic fatty liver disease in women: A longitudinal study based on a United Kingdom primary care database. PLoS Med. 2018; 15(3): e1002542.
    CrossRefPubMed
  157. Yao K, Zheng H, Peng H. Association between polycystic ovary syndrome and risk of non-alcoholic fatty liver disease: a meta-analysis. Endokrynol Pol. 2023; 74(5): 520–527.
    CrossRefPubMed
  158. Lin HY, Yu IC, Wang RS, et al. Increased hepatic steatosis and insulin resistance in mice lacking hepatic androgen receptor. Hepatology. 2008; 47(6): 1924–1935.
    CrossRefPubMed
  159. Dubois V, Laurent MR, Jardi F, et al. Androgen Deficiency Exacerbates High-Fat Diet-Induced Metabolic Alterations in Male Mice. Endocrinology. 2016; 157(2): 648–665.
    CrossRefPubMed
  160. Senmaru T, Fukui M, Okada H, et al. Testosterone deficiency induces markedly decreased serum triglycerides, increased small dense LDL, and hepatic steatosis mediated by dysregulation of lipid assembly and secretion in mice fed a high-fat diet. Metabolism. 2013; 62(6): 851–860.
    CrossRefPubMed
  161. Xia F, Xu X, Zhai H, et al. Castration-induced testosterone deficiency increases fasting glucose associated with hepatic and extra-hepatic insulin resistance in adult male rats. Reprod Biol Endocrinol. 2013; 11: 106.
    CrossRefPubMed
  162. Schwinge D, Carambia A, Quaas A, et al. Testosterone suppresses hepatic inflammation by the downregulation of IL-17, CXCL-9, and CXCL-10 in a mouse model of experimental acute cholangitis. J Immunol. 2015; 194(6): 2522–2530.
    CrossRefPubMed
  163. Jia Y, Yee JK, Wang C, et al. Testosterone replacement ameliorates nonalcoholic fatty liver disease in castrated male rats. Endocrinology. 2014; 155(2): 417–428.
    CrossRefPubMed
  164. Jia Y, Yee JK, Wang C, et al. Testosterone protects high-fat/low-carbohydrate diet-induced nonalcoholic fatty liver disease in castrated male rats mainly via modulating endoplasmic reticulum stress. Am J Physiol Endocrinol Metab. 2018; 314(4): E366–E376.
    CrossRefPubMed
  165. Barbonetti A, Caterina Vassallo MR, Cotugno M, et al. Low testosterone and non-alcoholic fatty liver disease: Evidence for their independent association in men with chronic spinal cord injury. J Spinal Cord Med. 2016; 39(4): 443–449.
    CrossRefPubMed
  166. Haider A, Gooren LJG, Padungtod P, et al. Improvement of the metabolic syndrome and of non-alcoholic liver steatosis upon treatment of hypogonadal elderly men with parenteral testosterone undecanoate. Exp Clin Endocrinol Diabetes. 2010; 118(3): 167–171.
    CrossRefPubMed
  167. Khodamoradi K, Khosravizadeh Z, Seetharam D, et al. The role of leptin and low testosterone in obesity. Int J Impot Res. 2022; 34(7): 704–713.
    CrossRefPubMed
  168. Mancini M, Pecori Giraldi F, Andreassi A, et al. Obesity Is Strongly Associated With Low Testosterone and Reduced Penis Growth During Development. J Clin Endocrinol Metab. 2021; 106(11): 3151–3159.
    CrossRefPubMed
  169. Fan C, Wei D, Wang L, et al. The association of serum testosterone with dyslipidemia is mediated by obesity: the Henan Rural Cohort Study. J Endocrinol Invest. 2023; 46(4): 679–686.
    CrossRefPubMed
  170. Pelusi C. The Effects of the New Therapeutic Treatments for Diabetes Mellitus on the Male Reproductive Axis. Front Endocrinol (Lausanne). 2022; 13: 821113.
    CrossRefPubMed
  171. Bril F, Ortiz-Lopez C, Lomonaco R, et al. Clinical value of liver ultrasound for the diagnosis of nonalcoholic fatty liver disease in overweight and obese patients. Liver Int. 2015; 35(9): 2139–2146.
    CrossRefPubMed
  172. Salmi A, di Filippo L, Ferrari C, et al. Ultrasound and FibroScan Controlled Attenuation Parameter in patients with MAFLD: head to head comparison in assessing liver steatosis. Endocrine. 2022; 78(2): 262–269.
    CrossRefPubMed
  173. Song YS, Fang CH, So BI, et al. Time course of the development of nonalcoholic Fatty liver disease in the Otsuka long-evans Tokushima Fatty rat. Gastroenterol Res Pract. 2013; 2013: 342648.
    CrossRefPubMed
  174. Laursen TL, Kjær MB, Kristensen L, et al. Clinical Progression of Metabolic-Associated Fatty Liver Disease Is Rare in a Danish Tertiary Liver Center. J Clin Med. 2022; 11(9).
    CrossRefPubMed
  175. Ekstedt M, Franzén LE, Mathiesen UL, et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology. 2006; 44(4): 865–873.
    CrossRefPubMed
  176. Rafiq N, Bai C, Fang Y, et al. Long-term follow-up of patients with nonalcoholic fatty liver. Clin Gastroenterol Hepatol. 2009; 7(2): 234–238.
    CrossRefPubMed
  177. Le P, Payne JY, Zhang Lu, et al. Disease State Transition Probabilities Across the Spectrum of NAFLD: A Systematic Review and Meta-Analysis of Paired Biopsy or Imaging Studies. Clin Gastroenterol Hepatol. 2023; 21(5): 1154–1168.
    CrossRefPubMed
  178. Wai CT, Greenson JK, Fontana RJ, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003; 38(2): 518–526.
    CrossRefPubMed
  179. Harrison SA, Oliver D, Arnold HL, et al. Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease. Gut. 2008; 57(10): 1441–1447.
    CrossRefPubMed
  180. Sterling RK, Lissen E, Clumeck N, et al. APRICOT Clinical Investigators. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006; 43(6): 1317–1325.
    CrossRefPubMed
  181. Sterling RK, Lissen E, Clumeck N, et al. APRICOT Clinical Investigators. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006; 43(6): 1317–1325.
    CrossRefPubMed
  182. Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007; 45(4): 846–854.
    CrossRefPubMed
  183. Rosenberg WMC, Voelker M, Thiel R, et al. European Liver Fibrosis Group. Serum markers detect the presence of liver fibrosis: a cohort study. Gastroenterology. 2004; 127(6): 1704–1713.
    CrossRefPubMed
  184. Calès P, Lainé F, Boursier J, et al. Comparison of blood tests for liver fibrosis specific or not to NAFLD. J Hepatol. 2009; 50(1): 165–173.
    CrossRefPubMed
  185. Stefanska A, Bergmann K, Suwała S, et al. Performance Evaluation of a Novel Non-Invasive Test for the Detection of Advanced Liver Fibrosis in Metabolic Dysfunction-Associated Fatty Liver Disease. Metabolites. 2024; 14(1).
    CrossRefPubMed
  186. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023; 77(5): 1797–1835.
    CrossRefPubMed
  187. Ryan MC, Itsiopoulos C, Thodis T, et al. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol. 2013; 59(1): 138–143.
    CrossRefPubMed
  188. Trovato FM, Catalano D, Martines GF, et al. Mediterranean diet and non-alcoholic fatty liver disease: the need of extended and comprehensive interventions. Clin Nutr. 2015; 34(1): 86–88.
    CrossRefPubMed
  189. Misciagna G, Del Pilar Díaz M, Caramia DV, et al. Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial. J Nutr Health Aging. 2017; 21(4): 404–412.
    CrossRefPubMed
  190. Kouvari M, Boutari C, Chrysohoou C, et al. ATTICA study Investigators. Mediterranean diet is inversely associated with steatosis and fibrosis and decreases ten-year diabetes and cardiovascular risk in NAFLD subjects: Results from the ATTICA prospective cohort study. Clin Nutr. 2021; 40(5): 3314–3324.
    CrossRefPubMed
  191. Eslam M, Sarin SK, Wong VWS, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. Hepatol Int. 2020; 14(6): 889–919.
    CrossRefPubMed
  192. Ma J, Hennein R, Liu C, et al. Improved Diet Quality Associates With Reduction in Liver Fat, Particularly in Individuals With High Genetic Risk Scores for Nonalcoholic Fatty Liver Disease. Gastroenterology. 2018; 155(1): 107–117.
    CrossRefPubMed
  193. Vilar-Gomez E, Pirola CJ, Sookoian S, et al. Impact of the Association Between PNPLA3 Genetic Variation and Dietary Intake on the Risk of Significant Fibrosis in Patients With NAFLD. Am J Gastroenterol. 2021; 116(5): 994–1006.
    CrossRefPubMed
  194. Johnson NA, Sachinwalla T, Walton DW, et al. Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology. 2009; 50(4): 1105–1112.
    CrossRefPubMed
  195. St George A, Bauman A, Johnston A, et al. Independent effects of physical activity in patients with nonalcoholic fatty liver disease. Hepatology. 2009; 50(1): 68–76.
    CrossRefPubMed
  196. Sung KC, Ryu S, Lee JY, et al. Effect of exercise on the development of new fatty liver and the resolution of existing fatty liver. J Hepatol. 2016; 65(4): 791–797.
    CrossRefPubMed

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