Nonalcoholic fatty liver disease: current concepts, epidemiology and management strategies

Nonalcoholic fatty liver disease (NAFLD) is now the most prevalent liver disease in the world. It involves a spectrum of conditions from hepatic steatosis to nonalcoholic steatohepatitis and liver fibrosis, and is a major cause of cirrhosis and hepatocellular carcinoma. It is defined by presence of steatosis in 5% of hepatocytes or more in the absence of other causes of fatty liver. The metabolic syndrome is the major known risk factor for NAFLD. Dietary contributors such as high fructose intake and coffee consumption appear to increase and decrease the risk of disease respectively, but these links are unclear. Genetic associations have also been identified. The estimated prevalence of the disease varies according to diagnostic method and population demographics. It appears to be a major issue in Europe with population studies showing up to 50% of the individuals are affected while in the USA one in three adults are estimated to have NAFLD. Laboratory investigations and ultrasound are typically first-line investigations. Fibrosis may be assessed noninvasively through transient elastography and biomarkers but liver biopsy remains the gold standard to quantify hepatic damage. Associated comorbidities include cardiovascular disease and chronic kidney disease. Weight loss, dietary changes and exercise are recommended in management. Medications should be considered to manage underlying risk factors including insulin resistance. Surgical options include bariatric procedures and liv...
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Review Articles Source Type: research

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Publication date: Available online 19 July 2019Source: Journal of Clinical and Experimental HepatologyAuthor(s): Suresh Gorka, Ghulam Mohd Gulzar, Ghulam Nabi Yattoo, Jaswinder Singh Sodhi, Gulzar Ahmad Dar, Mushtaq Ahmad Laway, Saurabh Kaushik, Neeraj Dhar, Syed Mushfiq, Riffat Abdul AzizAbstractBackground/ObjectiveOur data is one of the earliest study from Indian subcontinent on Velpatasvir/Sofosbuvir (VEL/SOF) combination in chronic hepatitis C (CHC). The primary end point was to evaluate the sustained virologic response (SVR-12) in CHC infected patients and to determine its effect in patients with HCV related cirrhosis...
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research
CONCLUSIONS: We report the first series in the literature of BRAFV600E-mutated ATC patients with locoregionally advanced disease treated with dabrafenib and trametinib followed by surgical resection. We demonstrated feasibility of complete ATC resection, decreased need for tracheostomy, high pathologic response rates, and durable locoregional control with symptom amelioration. PMID: 31319771 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
This study is designed to demonstrate the ability of photoacoustic imaging to noninvasively determine changes in tissue oxygenation that occur in mice's hind limb skeletal muscle as they age. Mice from two age cohorts were scanned bilaterally with a pulsed laser. The photoacoustic signal was unmixed to generate a parametric map of estimated oxygen saturation and then overlaid on grayscale ultrasound images. Tissue oxygenation measured in young and old mice was compared. Photoacoustic imaging visually and quantitatively showed the decrease in skeletal muscle oxygenation that occurs with age. Percent tissue oxygenation decre...
Source: Ultrasonic Imaging - Category: Radiology Tags: Ultrason Imaging Source Type: research
Authors: Sakairi Y, Nakajima T, Yoshino I Abstract Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a low-invasive modality that shows excellent sensitivity, specificity, and accuracy in the diagnosis of nodal metastasis of lung cancer. Thus, EBUS-TBNA has become the first choice for nodal staging of non-small cell lung cancer and an alternative to mediastinoscopy, which had long been the gold standard. EBUS-TBNA can be utilized not only for initial cancer staging but also for staging after treatment or for diagnostic purposes, including molecular diagnostics. Adequate s...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
Authors: Lima A, Ferin R, Bourbon M, Baptista J, Pavão ML Abstract In Azores, the standardized mortality rate for coronary artery disease (CAD) is nearly the double when compared to mainland Portugal. The aim of this study was to compare the prevalence of conventional CAD risk factors, as well as the plasma aminothiol profile (and its major determinants), between two groups of healthy subjects from Ponta Delgada (in Azores) and Lisbon (in mainland) cities, searching for precocious biomarker(s) of the disease. The study groups consisted of 101 healthy volunteers from Ponta Delgada (PDL) and 121 from Lisbon, a...
Source: Journal of Nutrition and Metabolism - Category: Nutrition Tags: J Nutr Metab Source Type: research
Authors: Lee JH Abstract Purpose: The study aimed to investigate the prevalence of hyperuricemia and its association with metabolic syndrome (MetS) and cardiometabolic risk factors (CMRFs) in Korean children and adolescents. Methods: This cross-sectional survey used data from the 7th Korea National Health and Nutrition Examination Survey (2016-2017), and 1,256 males and females aged 10-18 years were included. Hyperuricemia was defined when SUA levels were>6.6 mg/dL at 10-11 years of age (both sex), and>7.7 mg/dL for males at 12-18 years of age and>5.7 mg/dL for females at 12-18 years of age. MetS was d...
Source: Korean Journal of Pediatrics - Category: Pediatrics Tags: Korean J Pediatr Source Type: research
CONCLUSION: DDP can be used as an energy source for replacing part of corn, mannan oligosaccharide and also recommended as a potential alternative to antimicrobials in broilers diet. PMID: 31322081 [PubMed - as supplied by publisher]
Source: Recent Patents on Food, Nutrition and Agriculture - Category: Food Science Tags: Recent Pat Food Nutr Agric Source Type: research
Low lncRNA ZNF385D‑AS2 expression and its prognostic significance in liver cancer. Oncol Rep. 2019 Jul 16;: Authors: Zhang Z, Wang S, Liu Y, Meng Z, Chen F Abstract Hepatocellular carcinoma (HCC) is a common digestive system disease with no curative treatment. Zinc finger protein 385D antisense RNA 2 (ZNF385D‑AS2) is a long non‑coding RNA (lncRNA) that has been predicted to function in human diseases, including several types of cancer. Yet, it has not been investigated in relation to liver cancer. Thus, the present study was designed with an aim to elucidate the prognostic significance of ln...
Source: Oncology Reports - Category: Cancer & Oncology Tags: Oncol Rep Source Type: research
Authors: Karki A, Putra J, Kim SS, Laquaglia MJ, Perez-Atayde AR, Sadri-Vakili G, Vakili K Abstract Fibrolamellar hepatocellular carcinoma (FL‑HCC) is a variant of hepatocellular carcinoma (HCC) that most commonly affects adolescents and young adults and is associated with an extremely poor prognosis due to the lack of effective chemotherapeutic agents. Mutations in p53 are a common oncogenic driver in HCC but not in FL‑HCC. However, in tumors lacking a p53 mutation, the tumor suppressor activity of p53 has been revealed to be dysregulated in several different cancer types. One mechanism has been attributed to ...
Source: Oncology Reports - Category: Cancer & Oncology Tags: Oncol Rep Source Type: research
Hypoxia‑induced mitochondrial translocation of DNM1L increases mitochondrial fission and triggers mPTP opening in HCC cells via activation of HK2. Oncol Rep. 2019 Jun 27;: Authors: Cai M, He P, Fang DL Abstract Disturbed mitochondrial dynamics are closely associated with the progression of different types of cancer including hepatocellular carcinoma (HCC). However, the manner in which mitochondrial dynamics are regulated in HCC remains largely unclear. In the present study, via immunofluorescence, real‑time PCR and western blot analysis, the effects of dynamin‑1‑like (DNM1L) on mitochondrial tr...
Source: Oncology Reports - Category: Cancer & Oncology Tags: Oncol Rep Source Type: research
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