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2nd Edition of Non-alcoholic Fatty Liver Disease: From Lifestyle to Environmental Factors

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (20 May 2023) | Viewed by 14781

Special Issue Editor

Dr. Bruno Ramos-Molina

E-Mail Website
Guest Editor
Obesity and Metabolism Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
Interests: metabolism; obesity; diabetes; non-alcoholic fatty liver disease; nutrition; microbiota; metabolomics; epigenetics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Non-alcoholic fatty liver disease (NAFLD) is dramatically increasing in concert with the epidemics of both obesity and type 2 diabetes. NAFLD represents a spectrum of liver conditions ranging from simple steatosis (a relatively benign condition) to non-alcoholic steatohepatitis (NASH), which could result in fibrosis and ultimately to cirrhosis or hepatocarcinoma.

The pathogenesis of NAFLD has been extensively studied in the last decade. However, the mechanisms underlying its progression to NASH have not been fully deciphered. Emerging evidence has proposed that the physiopathology of NAFLD is highly influenced by several dietary and environmental factors. These factors could participate in the development and progression of the disease by inducing changes in gut microbiota and/or epigenetic modifications, among other mechanisms.

This 2nd Edition of the Special Issue seeks research papers on the impact of lifestyle and environmental factors on the pathogenesis of NAFLD. We especially encourage the submission of interdisciplinary work and multicountry collaborative research. We welcome original research papers using different study designs as well as systematic reviews and meta-analyses.

Dr. Bruno Ramos-Molina
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • non-alcoholic fatty liver disease
  • steatohepatitis
  • lifestyle
  • environmental factors
  • diet
  • microbiota
  • epigenetics

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Related Special Issue

Published Papers (5 papers)

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Research

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10 pages, 640 KiB  
Article
Impact on Prevalence of the Application of NAFLD/MAFLD Criteria in Overweight and Normal Weight Patients
by Ana Luisa Ordoñez-Vázquez, Eva Juárez-Hernández, Julia María Zuarth-Vázquez, Martha Helena Ramos-Ostos, Misael Uribe, Graciela Castro-Narro and Iván López-Méndez
Int. J. Environ. Res. Public Health 2022, 19(19), 12221; https://doi.org/10.3390/ijerph191912221 - 27 Sep 2022
Cited by 6 | Viewed by 2034
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome. Recently, the term metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed and adapted to body mass index (BMI). This study describes the impact on prevalence of the application [...] Read more.
Background: Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome. Recently, the term metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed and adapted to body mass index (BMI). This study describes the impact on prevalence of the application of both criteria in overweight and lean patients. Methods: Patients who were evaluated for liver steatosis by transient elastography were included and divided according to BMI (≥25 kg/m2 and <25 kg/m2) and classified as NAFLD or MAFLD, according to metabolic abnormalities. Differences in prevalence were evaluated applying both criteria. A multivariate analysis was performed to evaluate independent associations of metabolic abnormalities and liver steatosis in lean patients. Results: 3847 patients were included. In overweight patients (61%), the prevalence NAFLD was 63.6% and 65.3% for MAFLD (p = 0.22). In contrast, the prevalence of MAFLD was lower (7.9% vs. 18.3%, p ≤ 0.001) in lean patients. In this group, higher age, fasting glucose, triglycerides, and waist circumference showed independent association with liver steatosis. Conclusion: The application of NAFLD/MAFLD criteria did not show prevalence differences in overweight patients. With MAFLD criteria, the prevalence is lower in lean patients, but patients with high risk of progression of liver disease for steatosis were identified, according to their metabolic abnormalities. Full article
(This article belongs to the Special Issue 2nd Edition of Non-alcoholic Fatty Liver Disease: From Lifestyle to Environmental Factors)
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9 pages, 621 KiB  
Article
Historical Changes in Weight Classes and the Influence of NAFLD Prevalence: A Population Analysis of 34,486 Individuals
by Benjamin Kai Yi Nah, Cheng Han Ng, Kai En Chan, Caitlyn Tan, Manik Aggarwal, Rebecca Wenling Zeng, Jieling Xiao, Yip Han Chin, Eunice X. X. Tan, Yi Ping Ren, Douglas Chee, Jonathan Neo, Nicholas W. S. Chew, Michael Tseng, Mohammad Shadab Siddiqui, Arun J. Sanyal, Yock Young Dan and Mark Muthiah
Int. J. Environ. Res. Public Health 2022, 19(16), 9935; https://doi.org/10.3390/ijerph19169935 - 11 Aug 2022
Cited by 14 | Viewed by 2650
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally in tandem with the growing obesity epidemic. However, there is a lack of data on the relationship between historical weight changes 10 years ago and at present on NAFLD [...] Read more.
Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally in tandem with the growing obesity epidemic. However, there is a lack of data on the relationship between historical weight changes 10 years ago and at present on NAFLD prevalence at the population level. Therefore, we sought to evaluate the relationship between weight classes and the prevalence of NAFLD. Methods: Data were used from the United States National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Univariate and multivariate general linear model analyses were used to obtain risk ratio (RR) estimations of NAFLD events. Results: In total, 34,486 individuals were analysed, with those who were lean at both time points as the control group. Overweight (RR: 14.73, 95%CI: 11.94 to 18.18, p < 0.01) or obese (RR: 31.51, 95%CI: 25.30 to 39.25, p < 0.01) individuals at both timepoints were more likely to develop NAFLD. Residual risk exists where previously obese individuals became overweight (RR: 14.72, 95%CI: 12.36 to 17.52, p < 0.01) or lean (RR: 2.46, 95%CI: 1.40 to 4.31, p = 0.02), and previously overweight individuals who became lean (RR 2.24, 95%CI 1.42 to 3.54, p = 0.01) had persistent elevated risk of developing NAFLD despite weight regression. Sensitivity analysis identified that a higher proportion of individuals with regression in weight class were diabetics and Mexican Americans, while fewer African Americans saw weight-class regression. Conclusions: Residual risk exists in patients who lost weight despite the smaller magnitude of effect, and targeted weight reductions should still be used to mitigate the risk of NAFLD at the population level. Full article
(This article belongs to the Special Issue 2nd Edition of Non-alcoholic Fatty Liver Disease: From Lifestyle to Environmental Factors)
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12 pages, 834 KiB  
Article
Obstructive Sleep Apnea and Nonalcoholic Fatty Liver Disease in the General Population: A Cross-Sectional Study Using Nationally Representative Data
by Taeyun Kim, Hyunji Choi, Jaejun Lee and Jehun Kim
Int. J. Environ. Res. Public Health 2022, 19(14), 8398; https://doi.org/10.3390/ijerph19148398 - 9 Jul 2022
Cited by 5 | Viewed by 2241
Abstract
(1) Background: To evaluate the association between obstructive sleep apnea (OSA) and nonalcoholic fatty liver disease (NAFLD) in the general population using a nationally representative sample from South Korea; (2) Methods: This study included 4275 adults aged ≥40 years who completed the snoring, [...] Read more.
(1) Background: To evaluate the association between obstructive sleep apnea (OSA) and nonalcoholic fatty liver disease (NAFLD) in the general population using a nationally representative sample from South Korea; (2) Methods: This study included 4275 adults aged ≥40 years who completed the snoring, tiredness, observed apnea, high blood pressure, body mass index (BMI), age, neck circumference, and gender (STOP-Bang) questionnaire. The risk of OSA was stratified into low, intermediate, and high grades according to the STOP-Bang score. The prevalence of NAFLD according to the STOP-Bang score was calculated, and the increasing trend was measured. A complex sample multivariable regression analysis with adjustments for possible confounding variables was used to calculate the odds ratio of NAFLD and advanced fibrosis. Subgroup analysis was conducted with stratification based on sex and obesity status; (3) Results: We identified 1021 adults with NAFLD and 3254 adults without NAFLD. The prevalence of NAFLD increased significantly with higher STOP-Bang scores in both men and women. Participants of both sexes with high STOP-Bang scores were more likely to have NAFLD. Compared to non-obese individuals, the risk of NAFLD according to the STOP-Bang score was more intense in obese individuals. With respect to hepatic steatosis, there was no significant association between advanced fibrosis and STOP-Bang score; (4) Conclusions: OSA, the risk of which was measured using the STOP-Bang model, was closely associated with NAFLD in both Korean men and women. Clinicians should consider screening for NAFLD in individuals with a high STOP-Bang score. Full article
(This article belongs to the Special Issue 2nd Edition of Non-alcoholic Fatty Liver Disease: From Lifestyle to Environmental Factors)
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10 pages, 459 KiB  
Article
Quality of Life in Adults with Metabolic Dysfunction-Associated Fatty Liver Disease
by Tae-In Hwang and A-Lum Han
Int. J. Environ. Res. Public Health 2021, 18(24), 13145; https://doi.org/10.3390/ijerph182413145 - 13 Dec 2021
Cited by 9 | Viewed by 2488
Abstract
The aims of this study were as follows: to investigate the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and health-related quality of life (HRQoL), to evaluate whether stress perception and mental health among patients with MAFLD affect HRQoL, and to identify the [...] Read more.
The aims of this study were as follows: to investigate the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and health-related quality of life (HRQoL), to evaluate whether stress perception and mental health among patients with MAFLD affect HRQoL, and to identify the underrated burden on MAFLD patients. Nationwide data from the 5th Korean National Health and Nutrition Examination Survey (KNHANES V, 2010 to 2012) were used. MAFLD was defined by a fatty liver index (FLI) of ≥60, and the EuroQol-5D (EQ-5D) was used to assess HRQoL. Logistic regression analysis and odds ratios (ORs) were used to determine the associations of MAFLD with stress, mental health, and HRQoL. Previous suicidal impulse was not found to be significantly associated with HRQoL. The risk of MAFLD increased 1.265-fold with an increase in stress levels based on the stress perception rate (confidence index (CI): 1.046–1.530; p < 0.05), while it increased 1.091-fold with a 1-point decrease in the EQ-5D score (CI: 1.019–1.169; p < 0.05). HRQoL impairment and stress levels are associated with MAFLD. It is important to evaluate stress levels among MAFLD patients and implement stress management and HRQoL improvement strategies. Full article
(This article belongs to the Special Issue 2nd Edition of Non-alcoholic Fatty Liver Disease: From Lifestyle to Environmental Factors)

Review

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14 pages, 744 KiB  
Review
Are Ingested or Inhaled Microplastics Involved in Nonalcoholic Fatty Liver Disease?
by Teresa Auguet, Laia Bertran, Andrea Barrientos-Riosalido, Blanca Fabregat, Beatriz Villar, Carmen Aguilar and Fàtima Sabench
Int. J. Environ. Res. Public Health 2022, 19(20), 13495; https://doi.org/10.3390/ijerph192013495 - 18 Oct 2022
Cited by 21 | Viewed by 4251
Abstract
Nonalcoholic fatty liver disease (NAFLD) has emerged as the predominant cause of chronic liver injury; however, the mechanisms underlying its progression have not been fully elucidated. Pathophysiological studies have stated that NAFLD is significantly influenced by dietary and environmental factors that could participate [...] Read more.
Nonalcoholic fatty liver disease (NAFLD) has emerged as the predominant cause of chronic liver injury; however, the mechanisms underlying its progression have not been fully elucidated. Pathophysiological studies have stated that NAFLD is significantly influenced by dietary and environmental factors that could participate in the development of NAFLD through different mechanisms. Currently, “plastic pollution” is one of the most challenging environmental problems worldwide since several plastics have potential toxic or endocrine disputing properties. Specifically, the intake of microplastics (MPs) and nanoplastics (NPs) in water or diet and/or the inhalation from suspended particles is well established, and these particles have been found in human samples. Laboratory animals exposed to MPs develop inflammation, immunological responses, endocrine disruptions, and alterations in lipid and energy metabolism, among other disorders. MPs additives also demonstrated adverse reactions. There is evidence that MPs and their additives are potential “obesogens” and could participate in NAFLD pathogenesis by modifying gut microbiota composition or even worsen liver fibrosis. Although human exposure to MPs seems clear, their relationship with NAFLD requires further study, since its prevention could be a possible personalized therapeutic strategy. Adequate mitigation strategies worldwide, reducing environmental pollution and human exposure levels of MPs, could reduce the risk of NAFLD. Full article
(This article belongs to the Special Issue 2nd Edition of Non-alcoholic Fatty Liver Disease: From Lifestyle to Environmental Factors)
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