Non-alcoholic fatty liver disease (NAFLD) as a neglected metabolic companion of psychiatric disorders: common pathways and future approaches

BMC Medicine

Gerard Anmella¹  Nieves De Uribe-Viloria²  Andre F. Carvalho³  Michael Berk⁴  Brenda W. J. H. Penninx⁵  Óscar Soto-Angona⁶  María José Valdés-Florido⁷ 

[1] Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia;Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain;Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia;Department of Psychiatry, Hospital Clínico Universitario de Valladolid, Castilla y León, Spain;Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia;Department of Psychiatry, University of Toronto, Toronto, ON, Canada;Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada;Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia;Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry, and the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia;Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam University Medical Center/Vrije Universiteit & GGZinGeest, Amsterdam, the Netherlands;Department of Psychiatry, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119-129, 08035, Barcelona, Catalonia, Spain;Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia;UGC Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain;

关键词: Non-alcoholic fatty liver disease;    Metabolic syndrome;    Mental disorders;    Psychiatry;    Non-alcoholic steatohepatitis;    Non-communicable disorders;    Lifestyle;    Inflammation;    Oxidative stress;    Mitochondrial;   

DOI  :  10.1186/s12916-020-01713-8

来源: Springer

【 摘 要 】

BackgroundNon-alcoholic fatty liver disease (NAFLD) is characterized by hepatic steatosis in over 5% of the parenchyma in the absence of excessive alcohol consumption. It is more prevalent in patients with diverse mental disorders, being part of the comorbidity driving loss of life expectancy and quality of life, yet remains a neglected entity. NAFLD can progress to non-alcoholic steatohepatitis (NASH) and increases the risk for cirrhosis and hepatic carcinoma. Both NAFLD and mental disorders share pathophysiological pathways, and also present a complex, bidirectional relationship with the metabolic syndrome (MetS) and related cardiometabolic diseases.Main textThis review compares the demographic data on NAFLD and NASH among the global population and the psychiatric population, finding differences that suggest a higher incidence of this disease among the latter. It also analyzes the link between NAFLD and psychiatric disorders, looking into common pathophysiological pathways, such as metabolic, genetic, and lifestyle factors. Finally, possible treatments, tailored approaches, and future research directions are suggested.ConclusionNAFLD is part of a complex system of mental and non-communicable somatic disorders with a common pathogenesis, based on shared lifestyle and environmental risks, mediated by dysregulation of inflammation, oxidative stress pathways, and mitochondrial function. The recognition of the prevalent comorbidity between NAFLD and mental disorders is required to inform clinical practice and develop novel interventions to prevent and treat these complex and interacting disorders.

【 授权许可】

CC BY