Management of Non-alcoholic Fatty Liver Disease and the Role of Bariatric Surgery – A Brief Review for Surgeons

Nonalcoholic fatty liver disease (NAFLD) is closely linked to the metabolic syndrome and is highly prevalent in bariatric patients. The gold standard to diagnose NAFLD is a liver biopsy specifically to detect inflammatory changes characteristic of nonalcoholic steatohepatitis (NASH); technological advancements will improve the accuracy of current non-invasive modalities. Modification of risk factors via food management is important to prevent the progression of NAFLD to NASH and cirrhosis. Several clinical trials are underway for pharmacological treatment of NAFLD; currently the mainstay of treatment is insulin sensitizers and vitamin E.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Review articles 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
Authors: Serradilla Martín M, Oliver Guillén JR, Palomares Cano A, Ramia Ángel JM Abstract The term "metabolic syndrome" refers to a group of alterations comprising central obesity reduced high-density lipoprotein cholesterol concentrations, elevated triglyceride concentrations, arterial hypertension, and hyperglycemia. This syndrome has established itself as one of the epidemics of the 21st century. Among its causative agents are insulin resistance, leptin and adiponectin, changes in microbiota, and epigenetics. Its incidence in the European population is estimated to be around 25%. ...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig 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
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 accumula...
Source: Gastroenterology Clinics of North America - Category: Gastroenterology Authors: 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
Publication date: Available online 13 August 2019Source: Clinica Chimica ActaAuthor(s): Xin Su, Yi Kong, Daoquan PengAbstractNon-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in several developed countries, ranging from simple non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH) and cirrhosis. Currently, NAFLD has been confirmed to be associated with dyslipidemia, insulin resistance, and pre-diabetes, which are always grouped together as metabolic syndrome. Fibroblast growth factor 21 (FGF21) plays an important role in liver pathophysiology with multiple metabolic functi...
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
Abstract Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in several developed countries, ranging from simple non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH) and cirrhosis. Currently, NAFLD has been confirmed to be associated with dyslipidemia, insulin resistance, and pre-diabetes, which are always grouped together as metabolic syndrome. Fibroblast growth factor 21 (FGF21) plays an important role in liver pathophysiology with multiple metabolic functions. Accumulating evidence has shown that FGF21 could directly modulate lipid metabolism and reduce lipid a...
Source: International Journal of Clinical Chemistry - Category: Chemistry Authors: Tags: Clin Chim Acta Source Type: research
Fatty liver disease is characterized by a series of pathological conditions ranging from hepatic lipid accumulation (steatosis), to hepatocyte degeneration (ballooning), inflammation (steatohepatitis) and, eventually, cirrhosis and hepatocellular carcinoma [1,2]. Fatty liver disease may be the result of long-term excessive ethanol consumption, (alcoholic liver disease), or of visceral obesity and metabolic syndrome without ethanol consumption, leading to nonalcoholic fatty liver disease (NAFLD) which can evolve to nonalcoholic steatohepatitis (NASH) [3].
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research
More News: Alcoholism | Bariatric Surgery | Cirrhosis | Clinical Trials | Eating Disorders & Weight Management | Fatty Liver Disease (FLD) | Insulin | Liver | Liver Disease | Metabolic Syndrome | Non-alcoholic Fatty Liver Diseases (NAFLD) | Obesity | Surgery | Urology & Nephrology | Vitamin E | Vitamins