Aging and Nonalcoholic fatty liver disease

Abstract

Non-alcoholic liver disease, also known as NAFLD, is a prevailing and significant challenge of today’s medicine. As the statistics suggest, NAFLD affects 24% of the whole adult population (approximately 1 billion people worldwide). The disease sums the large specter of the liver diseases, from a simple steatosis to non-alcoholic steatohepatitis. It has been discovered, that NAFLD is a multisystemic disease, which has a great influence on many extrahepatic organs and regulatory pathways. Our review article aims to discuss different aspects of NAFLD related to aging. Aging is intertwined with physiological changes, such as decreased metabolism, hypertension, hyperlipidemia, obesity and insulin-resistency. Those factors play significant roles in the growing number of NAFLD cases. There are many theories that connect aged liver with NAFLD, however, the attention is concentrated on shortened telomeres, mitochondrial disfunction, cellular senescence and epigenetic changes. What’s more, the recent researches suggest that there is a correlation between liver function changes and the disruptions in the normal enteric microbiome. Mechanisms that suggest the familiariy of the aging proccesses and NAFLD call for further exploration, as they will be beneficial to plan targeted prevention and early intervention in a much optimal manner. Clinically, many patients of NAFLD are often asympomatic and their diagnosis is due to already developed fibrosis or comorbidities, such as portal hypertension and hepatocellular carcinoma. The diagnosis entails exclusion of other possible causes of the liver damage with the help of radiological and histological tests. On that note, imaging procedures and biopsy brings forward many following challenges, despite their valued assets. This calls for further academic discoveries. NAFLD treatment and management is multifaceted, two of the main methods being lifestyle modifications and pharmacotherapy, the latter being rather incomplete.