Association Between Non-alcoholic Fatty Liver Disease and Heavy Metal Exposure: a Systematic Review.

Non-alcoholic fatty liver disease (NAFLD) is a debilitating disease with adverse effects including cirrhosis and hepatocellular carcinoma. Heavy metals can cause severe dysfunction in different body organs including the liver. This review offers the study regarding the positive or negative association between heavy metals exposure and non-alcoholic fatty liver disease. The method used in this study is a systematic review based on searching in the PubMed, Scopus, and Science direct databases with the keywords of fatty liver, non-alcohol fatty liver, heavy metal, mercury, cadmium, arsenic, chromium, thallium, lead, iron, zinc, and nickel. There were 2200 articles searched in databases, and after assessment, 28 articles were selected. Positive association is established between arsenic, cadmium, iron, lead, mercury, and fatty liver disease. A negative relationship is found between zinc, copper, and progressive fatty liver disease. Furthermore, laboratory methods for NAFLD diagnosis were examined according to the obtained manuscripts. Among the different diagnostic methods, magnetic resonance imaging (MRI) is a sensitive method.