Non-Alcoholic Fatty Liver Disease: What Does the Primary Care Physician Need to Know?

NAFLD is defined as hepatic steatosis, either by imaging or histology, in the absence of secondary factors such as alcohol abuse, medications or other causes for fatty liver disease. Nonalcoholic steatohepatitis (NASH) is the association of steatosis with hepatocyte injury (hepatocyte ballooning) or with inflammation (hepatitis). In contrast to “simple” steatosis or nonalcoholic fatty liver (NAFL), NASH is often progressive and carries a significant risk of cirrhosis over time. This division is potentially dynamic, because NAFL can progress to NASH if metabolic (or other unknown) factors deteriorate and NASH can revert with treatment.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Review Source Type: research

Related Links:

AbstractThe growing burden of non-alcoholic fatty liver disease (NAFLD) parallels the increasing prevalence of obesity in Asia. The overall prevalence of NAFLD in Asia is now estimated to be 29.6% and may have surpassed that in Western populations. NAFLD increases with increasing age and is closely associated with metabolic syndrome. Ethnic differences exist in the prevalence of NAFLD, but the underlying factors are unclear. There were initial concerns about lean NAFLD being associated with more severe liver disease and increased mortality, but subsequent studies suggested otherwise. Only some NAFLD patients progress to de...
Source: Indian Journal of Gastroenterology - Category: Gastroenterology Source Type: research
Basel, 4 March 2020 - Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Device Designation to the Elecsys ® GALAD score.* This algorithmic score combines gender and age with the biomarker results of the Elecsys AFP, AFP-L3 and PIVKA-II and is intended to aid diagnosis of early stage hepatocellular carcinoma (HCC). Dr. Amit Singal, Medical Director of the Liver Tumor Program   and Clinical Chief of Pathology at UT Southwestern Medical Center in Dallas, USA, stated, " HCC is the fourth leading cause of cancer-related death worldwide, wit...
Source: Roche Investor Update - Category: Pharmaceuticals Source Type: news
AbstractObjectivesTo evaluate whether the liver and spleen volumetric indices, measured on portal venous phase CT images, could be used to assess liver fibrosis severity in chronic liver disease.MethodsFrom 2007 to 2017, 558 patients (mean age 48.7  ± 13.1 years; 284 men and 274 women) with chronic liver disease (n = 513) or healthy liver (n = 45) were retrospectively enrolled. The liver volume (sVolL) and spleen volume (sVolS), normalized to body surface area and liver-to-spleen volume ratio (VolL/VolS), were measured on CT images using a deep learning algorithm. The c...
Source: European Radiology - Category: Radiology Source Type: research
ConclusionA substantial further reduction in cases of HCC requires a wider application of universal HBV vaccination and effective treatment of HBV- and HCV-related chronic hepatitis and cirrhosis, more effective campaigns to favor correct dietary habits and reduce alcohol consumption and the intensification of studies on HCC pathogenesis for future optimized prevention strategies.
Source: Infection - Category: Infectious Diseases Source Type: research
In this report, we present the case of a patient who was diagnosed with primary biliary cholangitis and metabolic syndrome. Initial evaluation also revealed diabetes with elevated fasting plasma glucose and glycated hemoglobin. After eight weeks of treatment with ursodeoxycholic acid, a complete normalization of the hepatic biological tests was observed. A few months later, while body weight and abdominal perimeter remained stable, fasting blood glucose and glycated hemoglobin decreased significantly, compatible with diabetes disappearance. This finding supports the concept that the inflamed liver plays a major role in the...
Source: Acta Gastro-Enterologica Belgica - Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research
Abstract At present chronic liver disease (CLD), the third commonest cause of premature death in the United Kingdom is detected late, when interventions are ineffective, resulting in considerable morbidity and mortality. Injury to the liver, the largest solid organ in the body, leads to a cascade of inflammatory events. Chronic inflammation leads to the activation of hepatic stellate cells that undergo trans-differentiation to become myofibroblasts, the main extra-cellular matrix producing cells in the liver; over time increased extra-cellular matrix production results in the formation of liver fibrosis. Although ...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Abstract Cirrhosis is the 12th leading cause of death in the United States. Newer research has established that liver fibrosis is a dynamic process and that early cirrhosis may be reversible. Only one in three people with cirrhosis knows they have it. Most patients with cirrhosis remain asymptomatic until the onset of decompensation. When clinical signs, symptoms, or abnormal liver function tests are discovered, further evaluation should be pursued promptly. The most common causes of cirrhosis are viral hepatitis, alcoholic liver disease, and nonalcoholic steatohepatitis. Initial workup includes viral hepatitis se...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
Liver diseases, including liver cancer, cirrhosis, and nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH), impose a heavy disease burden worldwide [1,2]. Liver cancer and cirrhosis may derive from any chronic liver disease, such as hepatitis B/C virus (HBV/HCV) infections, alcoholic liver disease, NAFLD, haemochromatosis, and autoimmune hepatitis [3]. Over the last four decades, the prevalence of overweight has increased over fourfold in children, and there has been a great relative increase in obesity prevalence with no signs of slowing [4].
Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Correspondence Source Type: research
Authors: Sun L, Yin H, Liu M, Xu G, Zhou X, Ge P, Yang H, Mao Y Abstract Albumin is the most abundant plasma protein and albumin infusion is commonly used. Conventionally, the biologic and therapeutic effects of albumin have been thought to be due to its oncotic properties. However, albumin has a variety of biologic functions, including molecular transport, anti-oxidation, anti-inflammation, endothelial stabilization, anti-thrombotic effects, and the adjustment of capillary permeability. Despite this, the functions of albumin have not been thoroughly investigated. Recent studies have shown non-alcoholic fatty liver...
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research
ra Grieco The biological clock controls at the molecular level several aspects of mammalian physiology, by regulating daily oscillations of crucial biological processes such as nutrient metabolism in the liver. Disruption of the circadian clock circuitry has recently been identified as an independent risk factor for cancer and classified as a potential group 2A carcinogen to humans. Hepatocellular carcinoma (HCC) is the prevailing histological type of primary liver cancer, one of the most important causes of cancer-related death worldwide. HCC onset and progression is related to B and C viral hepatitis, alcoholic an...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
More News: Alcoholism | Cirrhosis | Fatty Liver Disease (FLD) | General Medicine | Hepatitis | Liver | Liver Disease | Non-alcoholic Fatty Liver Diseases (NAFLD) | Primary Care | Urology & Nephrology