NAFLD / NASH as a metabolic disease: improving patients outcomes

Prof. A.G.(Onno) Holleboom, Netherlands, discusses non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) as a metabolic disease and reviews management strategies in order to improve patients outcomes. He discusses the spectrum of NAFLD, where he presents a snapshot of the relative damages and repairs which focus on the NAFLD field in 2022. He then discusses the hepatic component metabolic syndrome (MetSy) and the mechanisms and pharmacological developments on NAFLD / NASH. For the clinicians he presents various statistics that summarise NAFLD / NASH as an ever more prevalent and severe liver disease.

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Cancers and NASH

Dr. Jean-François Dufour (Switzerland) reviews the association between cancers and NASH, where he highlights the causes of death in NAFLD patients, in which cardiovascular diseases and non-liver cancer with 38.3% and 18.7% are identified as some of the major causes. He then discusses NAFLD and cancer incidence rates by presenting the retrospective Korean study in 25,947 individuals conducted over an average period of 7.5 years and also reviews on the types of cancer that is associated with NAFLD. He also explains the interaction between NAFLD and breast cancer recurrence after curative surgery. Dr. Jean-François then discusses a retrospective cohort study on how bariatric surgery is associated with significant risk reduction for colorectal, pancreatic, endometrial, thyroid cancer, HCC and multiple myeloma. He also reviews various treatment options of HCC. Finally he presents the findings of efficacy of ICPIs in 3 Phase 3 RCTs and the retrospective cohort of efficacy of ICPIs in 130 cases with HCC.

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Link between NAFLD and HFpEF

Dr. Marat Fudim (USA) reviews the interaction between NAFLD and Heart Failure with preserved Ejection Fraction (HFpEF), including highlights of the global prevalence rate of NAFLD. He also discusses about NAFLD based on its progression, as a multi-system disease and how patients with a medical background of diabetes mellitus are at higher risk. He then reviews the association of NAFLD and various cardiac complications such as coronary heart disease, cardiac dysfunction, health failure, etc. Dr. Fudim also explains the etiological relationship between NAFLD and HFpEF which concludes that the downstream risk of HF was stronger in HFpEF in comparison with HFrEF. He also discusses the metabolic HFpEF phenotypes. Finally he presents the findings of a meta analysis of Incident Risk of HF after NAFLD.

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Interactions between gut microbiota and PPARs in NAFLD

Dr. Nicolas Lanthier (Belgium) reviews the interaction between the gut microbiota and PPARs in NAFLD. He discusses the microbiota and its link to NAFLD and IR, where he explains the key role of the gut microbes in the metabolism of their host and highlights how liver becomes the first organ to be exposed to gut changes. He also reviews the role of peroxisome proliferator-activated receptor (PPARs) in metabolism, inflammation and in vascular and fibrosis modulation. He explains the human bacterial microbiota changes and how it can relate to other metabolic changes such as adipose tissue expansion, muscle mass and myosteatosis. To clinicians, he presents patient studies on probiotic and prebiotics, and its impact at various disease stages such as NAFLD, NASH, overweight and obesity.

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