How to Identify the Patient with Nonalcoholic Steatohepatitis Who Will Progress to Cirrhosis

Non-alcoholic fatty liver disease (NAFLD) figures prominently into the clinical hepatology landscape. NAFLD represents a disease spectrum comprising simple steatosis, steatosis with elevated liver enzymes, and non-alcoholic steatohepatitis (NASH), the entity with clear potential for fibrosis progression. Risk factors associated with fibrosis progression in NASH include histologic findings of lobular inflammation and any fibrosis as well as clinical comorbidities that include type 2 diabetes, obesity, and metabolic syndrome. Liver biopsy remains the gold standard in evaluating NASH; however, noninvasive methods are accumulating evidence for a growing role in identifying patients at increased risk to develop NASH, fibrosis, and potentially cirrhosis.
Source: Gastroenterology Clinics of North America - Category: Gastroenterology Authors: Source Type: research

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Non-alcoholic Fatty Liver Disease (NAFLD) is the leading cause of liver disease worldwide with rising rates in parallel to those of obesity, type 2 diabetes and metabolic syndrome. NAFLD encompasses a wide spectrum of pathology from simple steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis, which are linked to poor outcomes. Studies confirm a significant amount of undiagnosed NAFLD and related fibrosis within the community increasing the overall burden of the disease. NAFLD appears to be more prevalent in certain populations such as those with type 2 diabetes and metabolic syndrome.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Review Source Type: research
Non-alcoholic fatty liver disease (NAFLD) comprises fatty liver (steatosis), non-alcoholic steatohepatitis (NASH) and fibrosis/cirrhosis and may lead to end-stage liver failure or hepatocellular carcinoma. NAFLD is tightly associated with the most frequent metabolic disorders, such as obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM). Both multisystem diseases share several common mechanisms. Alterations of tissue communications include excessive lipid and later cytokine release by dysfunctional adipose tissue, intestinal dysbiosis and ectopic fat deposition in skeletal muscle.
Source: Metabolism - Clinical and Experimental - Category: Biomedical Science Authors: Source Type: research
Abstract Liver cirrhosis and diabetes mellitus (DM) are both common conditions with significant socioeconomic burden and impact on morbidity and mortality. A bidirectional relationship exists between DM and liver cirrhosis regarding both etiology and disease-related complications. Type 2 DM (T2DM) is a well-recognized risk factor for chronic liver disease and vice-versa, DM may develop as a complication of cirrhosis, irrespective of its etiology. Liver transplantation (LT) represents an important treatment option for patients with end-stage liver disease due to non-alcoholic fatty liver disease (NAFLD), which repr...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
ConclusionsUnder a combination of leflunomide and methotrexate, liver toxicity and, for the first time, thrombotic microangiopathy occurred as side effects. Non-alcoholic fatty liver disease may have predisposed for the drug-induced liver toxicity.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
CONCLUSION: Despite some limitations of our study, such as the small number of patients, and the use of two different methods of evaluation (biopsy and elastography), the data obtained allow us to conclude that of the 39 evaluated cases, 33% (13) presented progression of fibrosis and the total group of 50 patients, 42% had cirrhosis or died due to liver disease. The presence of NASH on hepatic biopsy did not prove to be, in our study, a predictive of the evolution of hepatic fibrosis in the patients.RESUMO CONTEXTO: A doen ça hepática gordurosa não alcoólica vem sendo diagnosticada com frequ&eci...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
Non-alcoholic fatty liver disease (NAFLD) is a growing challenge to global public health. It is defined as the increased accumulation of hepatic triglyceride (>5%) in the absence of excessive alcohol consumption or other causes of liver disease. The NAFLD spectrum encompasses steatosis (non-alcoholic fatty liver, NAFL) and non-alcoholic steatohepatitis (NASH), an inflammatory form of the condition marked by the presence of hepatocyte damage and progressive fibrosis that may lead to cirrhosis.[1,2] Although NAFLD may occur in patients with normal weight, it is closely associated with the presence of the metabolic syndrom...
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research
Abstract Non-Alcoholic Fatty Liver Disease (NAFLD), the most common liver disease, is characterized by accumulation of fat (>5% of the liver tissue), in the absence of alcohol abuse or other chronic liver diseases. Its prevalence is increasing because of obesity, metabolic syndrome or Type 2 Diabetes Mellitus (T2DM). NAFLD can cause liver inflammation and progress to Non-Alcoholic Steatohepatitis (NASH), fibrosis, cirrhosis or Hepatocellular Cancer (HCC). Nevertheless, Cardiovascular Disease (CVD) is the most common cause of morbidity and mortality in NAFLD/NASH patients. Current guidelines suggest the use of p...
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research
[Microbiome &NASH - partners in crime driving progression of fatty liver disease]. Z Gastroenterol. 2019 Jul;57(7):871-882 Authors: Wree A, Geisler LJ, Tacke F Abstract Along with the increasing prevalence of obesity, metabolic syndrome and type 2 diabetes, non-alcoholic fatty liver disease (NAFLD) is rapidly increasing and poses a major challenge for gastroenterologists. Many studies have demonstrated that the microbiome is closely associated with the progression of nutrition-related diseases, especially of fatty liver disease. Changes in the quantity and quality of the intestinal flora, commonly...
Source: Zeitschrift fur Gastroenterologie - Category: Gastroenterology Authors: Tags: Z Gastroenterol Source Type: research
Abstract Non-alcoholic fatty liver disease (NAFLD) is histologically classified as either non-alcoholic fatty liver or non-alcoholic steatohepatitis (NASH). NASH is the progressive subtype of NAFLD. Individuals with NASH are at significant risk of developing hepatic fibrosis, cirrhosis, hepatocellular carcinoma, and liver-related and all-cause mortality. NAFLD is closely associated with obesity, type 2 diabetes mellitus (T2DM), metabolic syndrome, and cardiovascular events. Its prevalence is estimated to be above 30% in Turkey; and recent studies confirm this estimate. According to these studies, the prevalence of...
Source: The Turkish Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: Turk J Gastroenterol Source Type: research
Ali Mahzari1, Songpei Li1, Xiu Zhou1,2, Dongli Li2, Sherouk Fouda1, Majid Alhomrani1, Wala Alzahrani1, Stephen R. Robinson1 and Ji-Ming Ye1,2* 1Lipid Biology and Metabolic Disease Laboratory, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia 2School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, China The present study investigated the effects of matrine on non-alcoholic steatohepatitis (NASH) in mice induced by a methionine choline-deficient (MCD) diet and the mechanism involved. The study was performed in C57B/6J mice fed a MCD diet for 6 weeks to induce NAS...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
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