NASH covers a wide spectrum of disease severity and NAFLD is increasingly common worldwide ☂ and has become the principal cause of chronic liver disease.
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.
Fatty liver disease can be caused by many different autosomal recessive diseases. One includes Wilson’s disease, a condition which leads to abnormal copper accumulation in multiple organs. Cirrhosis is common in up to 30% of cases, as well as steatosis and steatohepatitis. Cystic fibrosis is another example, where steatosis is common and liver disease occurs in 0.1-3.6% of patients. Furthermore, alpha-1-antitrypsin deficiency and lysosomal acid lipase deficiency have been linked to steatosis accumulation, although have little research into their pathogenesis.
Non-alcoholic fatty liver disease (NAFLD) has a more progressive form, non-alcoholic steatohepatitis (NASH). In both conditions, inflammation is a key driver of the pathogenesis. There are various causes of metabolic injury in the conditions, leading to the activation of different immune cells such as hepatic Kupffer cells.
Non-alcoholic fatty liver disease (NAFLD) has a more progressive form, non-alcoholic steatohepatitis (NASH). In both conditions, inflammation is a key driver of the pathogenesis. Current treatments mostly focus on promoting weight loss (through encouraging lifestyle changes, or, if necessary, bariatric surgery) and improving comorbidities through pharmacotherapy, such as type 2 diabetes.
Published in Expert Rev Gastroenterol Hepatol 2021
Recently, a consensus recommended 'metabolic (dysfunction) associated fatty liver disease' as a more appropriate name to describe fatty liver disease associated with metabolic dysfunction (MAFLD). This single-letter change in the NAFLD acronym suggests that the old acronyms should be abandoned...
S. Ciardullo et G. Perseghin (Policlinico di Monza, and University of Milano Bicocca, Italy) performed a cross-sectional study of adults recruited in the 2017-2018 NHANES Survey, a representative sample of the general US population, in order to determine the prevalence of NAFLD, MAFLD and associated advanced fibrosis in the US population...
Our understanding of fatty liver syndromes and their relationship with the metabolic syndrome has improved over recent decades and, paralleling this, we are now at the dawn of the NAFLD (non-alcoholic fatty liver disease) to MAFLD (metabolic-associated fatty liver disease) transition. The pitfalls of NAFLD diagnosis...
Polarising opinions and major debate have recently arisen in hepatology on the nomenclature and diagnostic criteria for fatty liver disease associated with metabolic dysfunction.The aim of this viewpoint by Y. Fouad et al. (Faculty of Medicine, Minia University, Egypt) is to suggest...
Authors: Younossi ZM, Rinella ME, Sanyal AJ, et al.
Published in Hepatology 2021
Despite the substantial gains in our understanding of NAFLD/NASH over the past 2 decades, there has been some dissatisfaction with the terminology “non-alcoholic” which overemphasises “alcohol” and underemphasises the predisposing metabolic risk factors.
The term MAFLD is still suboptimal, leaving a great deal of ambiguity...
A systematic literature review to identify recent epidemiological, biomarker, genetic and clinical evidence that expands our understanding of NAFLD as a metabolic disorder was performed by B. Cariou et al. (Inserm, CNRS, France). It appears that here is a growing body of evidence on the links between NAFLD/NASH pathogenesis and mechanisms of metabolic dysfunction...
Globally, liver biopsy remains the reference standard for staging NAFLD severity. To diagnose NAFLD and quantify liver fat, MRI proton density fat fraction may be more informative than liver biopsy. In this review, V. Ajmera and R. Loomba (University of California, USA) critically examine the use...
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