Non-alcoholic fatty liver disease: Update on treatment options and translational implications of sleep disruption
Open Access
- 17 August 2021
- journal article
- Published by Heighten Science Publications Corporation in Annals of Clinical Gastroenterology and Hepatology
- Vol. 5 (1), 032-038
- https://doi.org/10.29328/journal.acgh.1001030
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a condition that is associated with cirrhosis and hepatocellular carcinoma, and is increasing in prevalence worldwide. Sleep disruptions are commonly seen in NAFLD, and the disease process is associated with sleep disorders, including obstructive sleep apnea, circadian rhythm disorders, and insufficient sleep. The intermittent hypoxia seen in obstructive sleep apnea may contribute to fibrotic changes in the liver. A major component of this linkage may be related to gut microbiome changes. One notable change is increase in Bacteroidetes/Firmicutes ratio, and decrease in flora that ferment fiber into anti-inflammatory short-chain fatty acids. Several therapeutic options exist for NAFLD that target both sleep and NAFLD, including non-pharmacological factors, such as lifestyle modification (mainly diet and exercise). Pharmacological options include melatonin, Vitamin E, thiazolidinediones, and fecal microbiota transplantation. Core tip The pathogenesis of non-alcoholic fatty liver disease is closely tied to sleep and circadian rhythm abnormalities, through shared inflammatory pathways and altered metabolism. This review explores the pathogenesis of NAFLD in the context of sleep and circadian abnormalities. The associated inflammatory response is linked to changes in gut-microbiome interactions that contribute to the disease process. Understanding of this linkage has implications for various therapies for disease mitigation.Keywords
This publication has 68 references indexed in Scilit:
- Regulation of circadian behaviour and metabolism by REV-ERB-α and REV-ERB-βNature, 2012
- Regulation of circadian behaviour and metabolism by synthetic REV-ERB agonistsNature, 2012
- Circadian regulation of pineal gland rhythmicityMolecular and Cellular Endocrinology, 2012
- Obstructive Sleep Apnea-Hypopnea Syndrome and Nonalcoholic Fatty Liver Disease: Emerging Evidence and MechanismsSeminars in Liver Disease, 2012
- Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trialsBMJ, 2010
- Pioglitazone, Vitamin E, or Placebo for Nonalcoholic SteatohepatitisThe New England Journal of Medicine, 2010
- Reduced liver fibrosis in hypoxia-inducible factor-1α-deficient miceAmerican Journal of Physiology-Gastrointestinal and Liver Physiology, 2009
- Randomized, Placebo-Controlled Trial of Pioglitazone in Nondiabetic Subjects With Nonalcoholic SteatohepatitisGastroenterology, 2008
- The role of melatonin in immuno‐enhancement: potential application in cancerInternational Journal of Experimental Pathology, 2006
- Nonalcoholic Fatty Liver Disease: From Steatosis to CirrhosisJournal of Hepatology, 2006