Non-Alcoholic Fatty Liver Disease Across Endocrine Diseases: From Pathophysiology to Novel Therapeutic Approaches

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About this Research Topic

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Background

Non-Alcoholic Fatty Liver Disease (NAFLD) is the most frequent form of chronic liver disease. It is linked mainly to insulin resistance arising in the multi-dimensional picture of metabolic syndrome (dyslipidemia, obesity and type 2 diabetes). However, many endocrine diseases may affect the liver (e.g. thyroid diseases, polycystic ovary syndrome, adrenal and gonadal disorders, pituitary gland dysregulations), but the disease burden and their clinical implications have not yet been fully investigated. In fact, the pathophysiology of NAFLD in endocrine diseases may account for specific sub-populations, allowing for a tailored phenotyping, with several implications. The prevalence, natural history, and prognosis of NAFLD across the endocrine diseases require a deeper elucidation, in order to improve diagnostic pathways and event therapeutic targets. In addition, longitudinal evidence on risk stratification and hard endpoint prevention is still missing.

This Research Topic aims to achieve a comprehensive overview of the burden of NAFLD across the endocrine diseases. The classical NAFLD phenotype arises from the several features of metabolic syndrome. However, different pathophysiology pathways may be involved in the setting of other endocrine disorders, including thyroid, adrenal glands, ovary, and pituitary gland, which will be elucidated in this Topic. In addition, the presence of NAFLD may add to the disease burden of the underlying endocrine disorder, leading to diverse phenotypes and progressiveness. Hence, this Topic will highlight the novel mechanistic insights of NAFLD in pre-clinical models of endocrine diseases, or in human cohorts. Additionally, updates on the prevalence, clinical presentation, and longitudinal findings will improve the current knowledge of the cross-talk between the liver and the endocrine organs. Novel treatment strategies are needed to treat NAFLD, and the exploration of the endocrine diseases may add to this crucial agenda. The higher proportion of endocrine diseases among younger individuals can improve the understanding of special clinical presentations of NAFLD that demand tailored diagnostic and treatment strategies.

This Topic aims to give a translational view of the burden of NAFLD across the endocrine diseases: obesity, dyslipidaemia, type 1 and 2 diabetes, thyroid, pituitary gland, adrenal glands, and gonads:

- epidemiology of NAFLD in the endocrine diseases;
- insights on diagnostic tools and non-invasive approaches;
- elucidations of the pathophysiological pathways involved in the onset of NAFLD in endocrine diseases, with potential novel drug targeting;
- highlights of the natural history, risk stratification, and hard endpoints of both liver and endocrine diseases based on longitudinal evidence

This Research Topic will include original research articles based on both pre-clinical and clinical investigations. Review articles and mini-reviews will be accepted, focusing on the following points:

- the current evidence of the NAFLD burden in endocrine diseases,
- the pathophysiological pathways that are involved,
- the diverse clinical presentation and severity,
- longitudinal evidence of the impact of NAFLD in endocrine diseases,
- therapeutic strategies

Keywords: Non-Alcoholic Fatty Liver Disease, NAFLD, NASH, Non-Alcoholic Steatohepatitis, liver fibrosis, thyroid disease, insulin resistance, type 2 diabetes, obesity, hypopituitarism, polycystic ovary syndrome, hypogonadism

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