Medical Education


From NAFLD to NASH: determining disease progression and regression rates

Authors: Noureddin and Wong
Published in Clinical Gastroenterology and Hepatology (May 2023)
The spectrum of non-alcoholic fatty liver disease (NAFLD) is divisible into three stages: 1) NAFL, 2) non-alcoholic steatohepatitis (NASH), NAFLD’s progressive and inflammatory subtype, and 3) NAFLD or NASH with fibrosis, whose stages range from F0-4.
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Phospholipid depletion and NAFLD pathophysiology: findings from lipidomics

Authors: Mocciaro G, Allison M, Jenkins B et al.
Published in Molecular Metabolism (April 2023)
Along with its association with metabolic syndrome, NAFLD is closely linked with mixed dyslipidaemia (reduced high-density lipoprotein cholesterol (HDL-C) and increased very low-density lipoprotein triglycerides (VLDL-TG)).
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Noninvasive tests for NAFLD: where are we now?

Authors: Alnimer L and Noureddin M
Published in Clinical and Molecular Hepatology (April 2023)
Up to 30% of patients with non-alcoholic fatty liver disease (NAFLD) progress to non-alcoholic steatohepatitis (NASH), significantly increasing their risk of fibrosis and associated adverse outcomes. As such, ensuring the early identification of NAFLD and NASH in at-risk patients is a clinical priority.
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Cardiovascular disease in MAFLD versus NAFLD: a review

Authors: Kang MK, Lee YR, Jang SY et al
Published in Hepatol Int (April 2023)
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.
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The “Perfect” NASH Biomarker: an Unrealistic Pursuit?

Authors: Sebastiani G
Published in Lancet Gastroenterol Hepatol 2023
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.
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T2D-Related Complications and its Impact on Fibrosis Levels: an Emerging Association?

Authors: Trivedi HD, Tran Q, Fricker Z et al.
Published in Annals of hepatology 2023
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.
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Non-Invasive Tests to Stratify NAFLD Based on Liver-Related Events: a Review

Authors: Boursier J, Hagström H, Ekstedt M, et al.
Published in J Hepatol 2022
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.
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