Update on NAFLD genetics: From new variants to the clinic

Eric Trépo, Luca Valenti

Research output: Contribution to journalReview article

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver diseases in high-income countries and the burden of NAFLD is increasing at an alarming rate. The risk of developing NAFLD and related complications is highly variable among individuals and is determined by environmental and genetic factors. Genome-wide association studies have uncovered robust and reproducible associations between variations in genes such as PNPLA3, TM6SF2, MBOAT7, GCKR, HSD17B13 and the natural history of NAFLD. These findings have provided compelling new insights into the biology of NAFLD and highlighted potentially attractive pharmaceutical targets. More recently the development of polygenic risk scores, which have shown promising results for the clinical risk prediction of other complex traits (such as cardiovascular disease and breast cancer), have provided new impetus for the clinical validation of genetic variants in NAFLD risk stratification. Herein, we review current knowledge on the genetic architecture of NAFLD, including gene-environment interactions, and discuss the implications for disease pathobiology, drug discovery and risk prediction. We particularly focus on the potential clinical translation of recent genetic advances, discussing methodological hurdles that must be overcome before these discoveries can be implemented in everyday practice.

Original languageEnglish
Pages (from-to)1196-1209
Number of pages14
JournalJournal of Hepatology
Volume72
Issue number6
DOIs
Publication statusPublished - Jun 2020

Keywords

  • Non-alcoholic fatty liver disease
  • Risk stratification
  • Steatohepatitis
  • Treatment

ASJC Scopus subject areas

  • Hepatology

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