Geographical burden of NAFLD: a review
Over the past few decades, non-alcoholic fatty liver disease (NAFLD) has become a growing problem, alongside the increasing rates of obesity and type 2 diabetes.
Over the past few decades, non-alcoholic fatty liver disease (NAFLD) has become a growing problem, alongside the increasing rates of obesity and type 2 diabetes.
In this study, a large, global, multidisciplinary panel discussed priorities within the field of fatty liver disease, including its burden, policies surrounding the issue and treatment options.
Currently, there are rising levels of non-alcoholic fatty liver disease (NAFLD). With this, comes a concurrent increase in hepatocellular carcinoma (HCC) cases.
Cardiometabolic syndrome (CMS) involves a complex interplay of many issues, involving obesity, metabolic dysregulation, cardiovascular disease, insulin resistance and more. This condition extends to clinical implications including non-alcoholic fatty liver disease (NAFLD) as well as cancer and sleep apnoea.
Generally, NASH and fibrosis correlate with the development of cirrhosis and other negative clinical outcomes. Treatments often aim to target inflammation, fibrosis, cell injury or metabolic dysregulation.
Changing the terminology from NAFLD, non-alcoholic fatty liver disease, to MAFLD, metabolic dysfunction-associated fatty liver disease, has been an ongoing debate. MAFLD is based upon an individual having hepatic steatosis, as well as either type 2 diabetes mellitus, obesity (or being overweight) or if at a normal weight, two or more metabolic risk abnormalities.
The rising healthcare costs of NASH highlight the need for early intervention. Higher FIB-4 scores correlate with increased healthcare expenses. Early-stage intervention can reduce the burden on patients and the healthcare system.
Heterogeneity in cut-off points for non-invasive fibrosis tests impacts NAFLD risk stratification. Standardized guidelines could improve consistency and accuracy in identifying patients requiring specialist care.
Physicians often underestimate or overestimate fibrosis severity in NASH, leading to concerns about appropriate treatment. Standardized interpretations of risk stratification tools are needed.
FIB4 and VCTE show promise in predicting prognosis for NAFLD patients. These non-invasive tests offer an alternative to liver biopsies for risk stratification. Quick and easily prescribed, they can streamline referrals and specialized management. A sequential algorithm with FIB4 and VCTE may improve NAFLD care.
Recurrence of NASH/NAFLD after liver transplantation requires attention. Factors include weight gain, post-transplant diabetes, and immunosuppressant drugs. Donor-related genetic risk factors also contribute. A multidisciplinary approach is essential for prevention and management.
Exercise training is 3.5 times more likely to achieve clinically meaningful treatment response in liver fat compared to standard clinical care for NAFLD patients, independent of significant weight loss.