NAFLD and obesity: regional differences and NASH as a driver of disease progression

Dysfunctional visceral adipose tissue is one of the major drivers and determinants of non-alcoholic fatty liver disease (NAFLD). Due to an inability to store excess energy in adipose tissue compartments, the body resorts to storing it in ectopic fat compartments. Compared with lean individuals, people who are overweight or obese are thus at a higher risk of developing NAFLD.
PUBLISHED IN: The Lancet Gastroenterology and Hepatology 2022

Comment:

Dysfunctional visceral adipose tissue is one of the major drivers and determinants of non-alcoholic fatty liver disease (NAFLD). Due to an inability to store excess energy in adipose tissue compartments, the body resorts to storing it in ectopic fat compartments. Compared with lean individuals, people who are overweight or obese are thus at a higher risk of developing NAFLD.

The aim of this article was to comment on the findings of Quek and colleagues’ study of NAFLD and non-alcoholic steatohepatitis’ (NASH) global prevalence in overweight and obese individuals.

Key learnings:

Quek and colleagues’ study found that the prevalence of advanced fibrosis was much higher in patients with NASH than in those with NAFLD. Interestingly, NASH only represents 45% of NAFLD cases. As such, it seems to be the main driver of fibrosis progression and is thus an important treatment target.
Furthermore, Quek and colleagues’ study also highlighted that while NAFLD prevalence was lower in Asian and Middle Eastern countries compared to those in North and South America, its severity was higher in the former territories compared to the latter. This opposition is relevant to national and international recommendations for NAFLD management and warrants further investigation.
Due to the presence of multiple confounding factors, the validity of these findings should be assessed by future studies. These must address some of the limitations of Quek and colleagues’ study, which notably include a lack of information on obesity class, body composition, and visceral adiposity.

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Dr. S Duarte

Dr. S Duarte

Articles: 31

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