Prof Sacks, Harvard Medical School, discusses the link between PPAR agonists and plasma lipid risk factors for cardiovascular disease. He explains how free fatty acids go to the liver and become lipotoxic. This activates inflammation in the liver which in turn reacts.
Non-alcoholic fatty liver disease (NAFLD) is tightly associated with the most frequent metabolic disorders, such as obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM).
. de Gottardi et al. (Gastroenterology and Hepatology, Ente Ospedaliero Cantonale, Lugano, Switzerland) present a case of SARS-CoV-2 infection reported in the literature in a liver transplanted patient
Prof Bedossa discusses the definition of NAFLD / NASH and the role of liver biopsy. Liver biopsy cannot be used as a screening tool but is essential in clinical trials. To be useful, it has to be of a good quality and optimised. Prof Bedossa shares best practices in this regard.
Changes in diet and lifestyle have led to a dramatic increase in the prevalence of NAFLD around the world. This is a meta-analysis of 9 studies, with a cumulative total of 951 participants, looking at the effect of physical activity on liver-specific endpoints: intra-hepatic fat content and serum aminotransferase activities improve.
In an experimental study, S. Lefere et al. investigated the efficacy of single and pan-PPAR agonists in the treatment of progressive steatohepatitis. The authors employed the CDAA-HFD (choline-deficient, amino acid-defined high-fat diet-induced) model, which induces severe inflammation and liver fibrosis. Mice were fed the CDAA-HFD for 12 weeks, and PPAR agonist treatment was administered during the last 6 weeks of diet feeding.
This meta-analysis of 6 trials using Sodium glucose co-transporter2 (SGLT2) inhibitors to treat type 2 diabetes mellitus reports that SGLT2 inhibitors can significantly decrease alanine amino-transferase ALT and liver fat, accompanying with weight loss, which may have a positive effect on fatty liver in patients with T2DM.
According to this work, including 7033 subjects for the period of 2001-2016, less than 5% of these patients are aware of having LD. Over the study duration, an increase in BMI, waist circumference, diabetes, and HbA1c; and a decrease in the number of smokers, platelets count, bilirubin, total cholesterol, and LDL level were noticed (p < 0.001). Educational programs to increase awareness of LD and risk factors for NAFLD should be implemented on a large scale.
In this study, J. Boeckmans et al. (Faculty of Medicine and Pharmacy, Vrije Universiteit, Brussels, Belgium) reproduced key NASH characteristics in vitro by exposing primary human hepatocytes, human skin stem cell-derived hepatic cells, HepaRG and HepG2 cell lines, as well as LX-2 hepatic stellate cells to multiple factors that play a role in the onset of NASH.
NAFLD, the liver is both victim and motor of a multisystem disease. Liver disease is not limited to the liver itself but has an impact on glycemic control in the body. Prof. Tacke discusses this vicious cycle and how NAFLD may add to coexisting risk factors and is predictor of morbidity and mortality. He shows why this is also important to develop new treatment strategies.
This retrospective study of Chinese patients (385) with NAFLD investigated changes in the level of serum 25-OH vitamin D [25-hydroxyvitamin D, 25(OH)D] in patients with non-alcoholic fatty liver disease (NAFLD) and the correlation between the severity of NAFLD and 25(OH)D. The analysis showed that they have lower 25-hydroxyvitamin circulating levels than controls. This confirms previous results.
Yann Colardelle / Med Ed GS
27 rue Raffet, 75016 Paris, France