Abstract
Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that have been associated
with an increased risk of developing nonalcoholic fatty liver disease (NAFLD). Insulin
resistance and central obesity are the key components of MetS, ultimately leading
to liver fat accumulation and the subsequent development of necroinflammatory liver
injury. However, the origin and nature of the metabolic stressors responsible for
stimulating the progression of simple steatosis to nonalcoholic steatohepatitis (NASH)
remain to be clearly identified. In addition, epidemiologic research on the association
between MetS and NAFLD has provided only limited information to guide the development
of targeted interventions, in particular, nutrition and pharmacologic prevention programs.
This review summarizes the evidence supporting the proposal that NAFLD is not invariably
associated with the presence of MetS, and mechanisms other than insulin resistance
may contribute to the chronic inflammatory processes that underpin the development
of liver fat accumulation and the subsequent architectural distortion of the liver.
A special focus is given to increased hemoglobin as a risk factor for the development
of NAFLD in the absence of MetS.
Keywords
nonalcoholic fatty liver disease - metabolic syndrome - risk factors - hemoglobin
