Treating fatty liver for the prevention of cardiovascular diseases.

摘要

We read with great interest the article by Speliotes et al.,1 who have demonstrated that fatty liver is associated with the main features of metabolic syndrome (MetS) independently of visceral fat in the well-known population of the Framingham Heart Study. The study potently shows that the quantity of liver fat, as measured by multidetector computed tomography, predicts the presence of the typical glucose and lipid metabolic disturbances of MetS in an independent manner. Interestingly, the study also demonstrates that fatty liver is associated with an increase in blood pressure. Because of the cross-sectional nature of the study, in their conclusion, the authors show caution in interpreting their findings as proof of concept of the pivotal role of liver fat ih the pathophys-iology of cardiovascular events in MetS. Nonetheless, we suggest that their findings could have been strengthened if the authors had taken into account recent findings coming from translational research. In particular, Korenblat et al.2 first showed that insulin action in the liver, muscle, and adipose tissue is directly related to the intrahepatic triglyceride (IHTG) content in obese subjects, and these findings were further extended by Fabbrini et al., who elegantly demonstrated that the IHTG content predicts the impairment of insulin action in the liver, adipose tissue, and muscle better than visceral fat.