Prof Bugianesi, Italy, reviews a burning issue: hepatocellular carcinoma (HCC) in patients with NAFLD/ NASH. She reviews the epidemiology globally and impact on liver transplant. There are multiple risks factors for HCC in NASH patients such as obesity, type 2 diabetes (T2D), and the metabolic syndrome in general. For clinicians, she presents the main studies, the profiles of the patients particularly at risk and risk stratifications strategies.
Prof Schattenberg, Germany, reviews how NASH impacts quality of life. He presents the mechanisms underlying metabolic comorbidities in NASH and discusses the relevant NASH phenotypes. A presentation of the tools that can be used to review health-related quality of life (HQRL) is particularly relevant for clinicians.
Prof Sanyal, USA, reminds us that NAFLD is the most common liver disease and reviews the comorbidities associated with NAFLD, and particularly the association with cardiovascular disease. He makes the point that NASH is part of a multi-system disorder and also presents the key concepts related to management, including risk stratification. An important learning is not to miss opportunities of early identification of patients at risks to improve the patients’ journey.
There is a need for new biomarkers that allow the detection and quantification of liver diseases supported on the measurement of fat, iron, fibrosis, inflammation. Dr Romero-Gomez presents a state-of-the-art video on imaging biomarkers with the pros and cons for each technology. For daily practice, he also suggests a diagnosis algorithm
As the International NASH day draws more attention to NASH, it’s important to remember that hepatocarcinoma (HCC) is the 2nd most common cause of cancer related death. Dr M. Peiseler and Dr F. Tacke, Charité hospital, Berlin, Germany present the latest scientific information about NASH as a systemic disease, represented by a common inflammatory ‘NAFLD phenotype’ of myeloid cells in liver and bone marrow. They highlight the role of inflammation and its multiple markers.
Prof Tacke, Germany reviews the epidemiological challenge of NAFLD and NASH worldwide, especially with the obesity pandemic. He describes the clinical impact of inflammation and fibrosis in NAFLD and the role of macrophages. Finally, he discusses the possible therapeutic implications. Credit : 4th global NASH congress 2021
It is well known that NAFLD and T2DM occur commonly together. Prof Byrne (Southampton, UK) discusses the latest findings showing that NAFLD is an independent risk factor for cardiovascular events. The aetiology of increased risk of CVD is complex but the atherogenic dyslipidaemia is important. Genotypes can increase severity of liver disease and diabetes, yet attenuate risk of CVD.
n this great pedagogical video, Prof Chris Byrne, UK illustrates that NAFLD is a risk factor for other extra hepatic diseases beyond the liver. He explains the natural history of NAFLD and shows that it is a multisystem disease with effects beyond the liver: risk of extra-hepatic complications (CVD, T2DM, CKD, and certain cancers)
As the 28th European congress on Obesity draws near, Prof Cusi, USA explains a paradigm shift and why drugs that have had an impact for CV disease also have a significant potential in the management of NASH. Amongst them, PPARs may have a role to play in addition to management of obesity and lifestyle interventions.