Synergy or overlap: non-alcoholic fatty liver disease and coronary heart disease a plea for computational epidemiology and multi-omics approaches

Non-alcoholic fatty liver disease (NAFLD) is increasing in prevalence around the world. It is associated with the metabolic syndrome with cardiovascular disease the most usual cause of death. Clinical methods used to screen for NAFLD on a preliminary basis include the use of multiple algorithms, based on non-invasive serum biomarkers. The presence of NAFLD has been linked to surrogate markers of cardiovascular disease such as carotid intima-media thickness, the presence of carotid plaque, brachial artery vasodilatory responsiveness and CT coronary artery calcification scores. The issue of whether NAFLD is a cardiovascular risk factor itself needs to be fully determined, but it frequently coexists with insulin resistance, the metabolic syndrome and type 2 diabetes. There is no specific medical treatment for NAFLD and the evidence is incomplete with respect to the efficacy of interventions that reduce cardiovascular risk. Management of patients with NAFLD should involve identification of risk factors with key points being lifestyle change and the treatment of underlying diabetes, dyslipidemia and hypertension. Managing big data - which must be achieved and validated in advance as much as possible – should be processed by comprehensive computational epidemiology and “-omics” approaches, taking into account advanced research challenging heterogeneity. Validation and replication are mandatory before utilizing “-omic” biomarkers in diagnostics to identify patients at risk of advanced disease, including coronary heart disease