Nonalcoholic fatty liver disease and aging: Epidemiology to management

Table 1 Anatomical and physiological changes associated with aging liver

Increased fibrosis with reduced percentage of fat on liver biopsy[3,4]; decreased size mirroring decreased hepatic blood flow[5]

Loss of regenerative capacity, i.e. “replicative senescence” involving cross talks of growth hormone, glycogen synthase kinase 3β and cyclin D3 and shortening of telomeric ends of chromosomes[5,6]

Increased inflammatory changes, hence the definition of “inflamm-aging” which, in its turn, has a detrimental effect on the regenerative response[7]

Defective autophagy[8,9]

Decrease in hepatic free radical scavenging system leads to increased oxidative stress resulting mainly from non-enzymatic processes in the liver[5] and is exacerbated by ethanol drinking[10]