Sarcopenia in Non-alcoholic Fatty Liver Disease: New challenges for clinical practice.

Sarcopenia in Non-alcoholic Fatty Liver Disease: New challenges for clinical practice. Expert Rev Gastroenterol Hepatol. 2020 Feb 17;: Authors: El Sherif O, Dhaliwal A, Newsome PN, Armstrong M Abstract Introduction: Sarcopenia is increasingly recognised in patients with non-alcoholic liver disease (NAFLD). Initially recognised as a consequence of advanced liver disease, there is now emerging evidence that sarcopenia may be a novel risk factor for the development of NAFLD, with a role in fibrosis and disease progression.Areas covered: This review examines the epidemiology, pathogenesis and complex interplay between NAFLD and sarcopenia. Furthermore, the authors discuss the challenges with diagnosis of sarcopenia in the clinic and the evidence-based management of sarcopenia in patients with NAFLD. A MEDLINE and PubMed search was undertaken using the terms; "sarcopenia", "frailty", "muscle", "obesity", "non-alcoholic fatty liver disease", "non-alcoholic steatohepatitis" and "cirrhosis" up to 31st September 2019.Expert opinion: Sarcopenia may be masked by the co-existence of morbid obesity, which is most notable in patients with NAFLD. Sarcopenia is a key indicator of adverse outcomes in patients with cirrhosis, such as hepatic decompensation, poor quality of life and premature mortality. Patients with NAFLD and advanced fibrosis/cirrhosis should undergo anthropometric measures (hand grip s...
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

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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
AbstractTherapeutics aimed at treating non-alcoholic fatty liver disease (NAFLD) target the pathogenic process from deranged metabolism leading to steatosis to cell stress and death, leading to a cascade of inflammation and fibrosis, ultimately culminating into cirrhosis. The development of drugs for management of NAFLD has bloomed over the past decade, although at present there is no approved pharmacological agent for its management. Not all patients with the disease progress to cirrhosis and decompensation; hence, treatment specifically is provided for those with a high risk of progression such as those with biopsy-prove...
Source: Indian Journal of Gastroenterology - Category: Gastroenterology Source Type: research
AbstractPurposeBariatric surgery can improve non-alcoholic fatty liver disease (NAFLD). Yet data on the effect on fibrosis are insufficient and controversial. This work endeavored to evaluate the safety of laparoscopic sleeve gastrectomy (LSG) in cases that have compensated non-alcoholic steatohepatitis (NASH)-related cirrhosis and its impact on fibrosis stage.MethodsThe current prospective work involved 132 cases with Child-A NASH-related cirrhosis suffering from morbid obesity scheduled for LSG. They were subjected to preoperative assessment, wedge biopsy, and ultrasound-guided true-cut liver biopsy after 30  months...
Source: Surgical Endoscopy - Category: Surgery 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
AbstractBariatric and metabolic surgery is associated with significant improvement in obesity-related comorbidities, but for patients with non-alcoholic fatty liver disease (NAFLD), clinical outcomes are dependent on the severity of liver disease, i.e. improvement of NAFLD in most patients but increased risks of fulminant hepatic failure and/or bleeding varices in patients with more advanced cirrhosis. Our study showed that absolute values of liver enzymes were poor indicator of risk of liver fibrosis. The use of AST/ALT ratio, Fib 4 or NAFLD scores were appropriate screening tools, with each risk score appearing to pick o...
Source: Obesity Surgery - Category: Surgery Source Type: research
Abstract Nonalcoholic fatty liver disease (NAFLD) is rapidly becoming the most common cause of chronic liver disease worldwide. This is primarily driven by the global epidemic of obesity and diabetes as well as the ageing of the general population. Most of the data regarding the epidemiology of NAFLD is published from the studies originating in the U.S. The overall prevalence of NAFLD in the United States is estimated to be 24%. In the U.S., Hispanic Americans have a higher prevalence of NAFLD, whereas African Americans have lower prevalence of NAFLD. The exact contributions of genetic and environmental factors on...
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
CONCLUSIONS: Based on these results, 8.1% of Mexican general population without a history of liver disease is at high risk of having advanced liver fibrosis and complications and death derived from cardiovascular disease and cirrhosis. Most of them showed normal ALT serum levels. PMID: 32063504 [PubMed - as supplied by publisher]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Semin Liver Dis DOI: 10.1055/s-0040-1701443Alcohol and obesity are the main risk factors for alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD), respectively, and they frequently coexist. There are considerable synergistic interaction effects between hazardous alcohol use and obesity-associated metabolic abnormalities in the development and progression of fatty liver disease. Intermittent binge-drinking has been shown to promote steatohepatitis from obesity-related steatosis, and binge-drinking is associated with progression to cirrhosis even when average alcohol intake is within the currently used criter...
Source: Seminars in Liver Disease - Category: Gastroenterology Authors: Tags: Review Article 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
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
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