Authors: Kalavalapalli S, Leiva EG, Lomonaco R et al.
Published in Journal of Clinical Endocrinology and Metabolism (April 2023)
Understanding the drivers of non-alcoholic fatty liver disease (NAFLD) is crucial to developing pharmacotherapies that effectively target it. Insulin resistance (IR), whose onset precipitates type 2 diabetes (T2D), is known to play a crucial role in the development of hepatic steatosis.
Published in Frontiers in Physiology (February 2023)
According to transient elastography-derived data, non-alcoholic fatty liver disease (NAFLD)’s prevalence in the United States (US) has increased from 18% in 1988-1991 to an estimated 25-50% in recent years.
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.
Seeking the perfect NASH biomarker may be unrealistic; versatility is key. A diverse biomarker pool adapts to varied clinical contexts and settings. FIB-4, a cost-effective marker, can be supplemented by complex multimarkers for NASH therapeutic trials. Embracing diagnostic imperfections is crucial for flexible biomarker algorithms.
NAFLD's prevalence in IBD patients raises concerns for cardiovascular risk. The study found doubled atherosclerotic cardiovascular disease risk in IBD patients with NAFLD. Transient elastography may predict cardiovascular risk in IBD patients. Targeted risk assessments are crucial for IBD patients with NAFLD.
Physicians often underestimate or overestimate fibrosis severity in NASH, leading to concerns about appropriate treatment. Standardized interpretations of risk stratification tools are needed.
Patients with T2D complications have a 4.5x greater risk of developing fibrosis, independent of HbA1c levels. FIB-4 index can help identify diabetic patients at highest risk, improving primary care screening.
Using Global Burden of Disease data, P. Golabi et al. (Inova Health System, USA) aimed to assess the incidence, mortality, and disability-adjusted life years attributable to NAFLD-related liver complications in Asia, the Middle East and North Africa. As stated by the authors in their conclusion, “NAFLD is poised to contribute to a substantial...
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