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Review

Non-Alcoholic Fatty Liver Disease (NAFLD) and Potential Links to Depression, Anxiety, and Chronic Stress

1
Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
2
Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
3
Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece
4
Centre for Active Living, University Centre Shrewsbury, University of Chester, Shrewsbury SY3 8HQ, UK
5
Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
6
School of Psychology, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
7
Sowe Valley Primary Care Network, Forum Health Centre, Coventry CV2 5EP, UK
8
Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
9
Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editors: Juan Manuel Pericas, Andreea Ciudin and Francisco Javier Cubero
Biomedicines 2021, 9(11), 1697; https://doi.org/10.3390/biomedicines9111697
Received: 24 October 2021 / Revised: 11 November 2021 / Accepted: 13 November 2021 / Published: 16 November 2021
(This article belongs to the Special Issue Metabolic Syndrome and NASH: From Molecular Basis to Therapy)
Non-alcoholic fatty liver disease (NAFLD) constitutes the most common liver disease worldwide, and is frequently linked to the metabolic syndrome. The latter represents a clustering of related cardio-metabolic components, which are often observed in patients with NAFLD and increase the risk of cardiovascular disease. Furthermore, growing evidence suggests a positive association between metabolic syndrome and certain mental health problems (e.g., depression, anxiety, and chronic stress). Given the strong overlap between metabolic syndrome and NAFLD, and the common underlying mechanisms that link the two conditions, it is probable that potentially bidirectional associations are also present between NAFLD and mental health comorbidity. The identification of such links is worthy of further investigation, as this can inform more targeted interventions for patients with NAFLD. Therefore, the present review discusses published evidence in relation to associations of depression, anxiety, stress, and impaired health-related quality of life with NAFLD and metabolic syndrome. Attention is also drawn to the complex nature of affective disorders and potential overlapping symptoms between such conditions and NAFLD, while a focus is also placed on the postulated mechanisms mediating associations between mental health and both NAFLD and metabolic syndrome. Relevant gaps/weaknesses of the available literature are also highlighted, together with future research directions that need to be further explored. View Full-Text
Keywords: non-alcoholic fatty liver disease; NAFLD; NASH; metabolic syndrome; insulin resistance; obesity; depression; anxiety; stress; health related quality of life non-alcoholic fatty liver disease; NAFLD; NASH; metabolic syndrome; insulin resistance; obesity; depression; anxiety; stress; health related quality of life
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MDPI and ACS Style

Shea, S.; Lionis, C.; Kite, C.; Atkinson, L.; Chaggar, S.S.; Randeva, H.S.; Kyrou, I. Non-Alcoholic Fatty Liver Disease (NAFLD) and Potential Links to Depression, Anxiety, and Chronic Stress. Biomedicines 2021, 9, 1697. https://doi.org/10.3390/biomedicines9111697

AMA Style

Shea S, Lionis C, Kite C, Atkinson L, Chaggar SS, Randeva HS, Kyrou I. Non-Alcoholic Fatty Liver Disease (NAFLD) and Potential Links to Depression, Anxiety, and Chronic Stress. Biomedicines. 2021; 9(11):1697. https://doi.org/10.3390/biomedicines9111697

Chicago/Turabian Style

Shea, Sue, Christos Lionis, Chris Kite, Lou Atkinson, Surinderjeet S. Chaggar, Harpal S. Randeva, and Ioannis Kyrou. 2021. "Non-Alcoholic Fatty Liver Disease (NAFLD) and Potential Links to Depression, Anxiety, and Chronic Stress" Biomedicines 9, no. 11: 1697. https://doi.org/10.3390/biomedicines9111697

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