Home › Forums › Other Specialities › Gastroenterology › NAFLD (Non Alcoholic Fatty Liver Disease. Ref ;Medscape
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May 8, 2013 at 2:18 am #2638AnonymousInactive
The epidemic of obesity has brought significant health-related consequences. Obesity-related fatty liver disease has surpassed other disorders to become the leading cause of chronic liver disease in the United States and a major indication for liver transplantation. Abstract presentations and talks given by invited faculty highlighted key advances in our understanding of mechanisms as well as diagnostic and management approaches to patients with fatty liver disease.
Recognition that nonalcoholic fatty liver disease (NAFLD) is a major health burden for patients of all ages is increasing. For example, research presented here[1] reported the annual prevalence of NAFLD in more than 7 million individuals registered with the Veterans Administration system. NAFLD increased from less than 1% 10 years ago to 8.5% in 2011. Furthermore, a recent study[2] suggested that the prevalence of NAFLD in adolescents has more than doubled in the past 20 years.The epidemic of obesity has brought significant health-related consequences. Obesity-related fatty liver disease has surpassed other disorders to become the leading cause of chronic liver disease in the United States and a major indication for liver transplantation. Abstract presentations and talks given by invited faculty highlighted key advances in our understanding of mechanisms as well as diagnostic and management approaches to patients with fatty liver disease.
Recognition that nonalcoholic fatty liver disease (NAFLD) is a major health burden for patients of all ages is increasing. For example, research presented here[1] reported the annual prevalence of NAFLD in more than 7 million individuals registered with the Veterans Administration system. NAFLD increased from less than 1% 10 years ago to 8.5% in 2011. Furthermore, a recent study[2] suggested that the prevalence of NAFLD in adolescents has more than doubled in the past 20 years.Diagnosis of Fatty Liver Disease
Reports also focused on other diagnostic methods, emphasizing that the standard approach (measurement of liver enzymes such as ALT and aspartate aminotransferase) performed poorly for diagnosing fatty liver disease. An elevated ALT:triglyceride ratio was reported to be a simple and noninvasive diagnostic test.[11] In another study,[12] cytokeratin 18 fragment levels were shown to be a surrogate biomarker for the presence of NASH.(Non Alcoholic Steato Hepatitis.)
Hepatic ultrasonography is the imaging modality most commonly used to screen for steatosis. However, it requires expert interpretation and fails to evaluate the degree of liver injury. Therefore, investigators[13] attempted to quantify and correlate the degree of liver stiffness as measured by sonoelastography imaging during ultrasound examination. They found that the degree of stiffness correlated with elements of the metabolic syndrome such as insulin resistance and the degree of liver injury and fibrosis.A reported pilot study[15] prospectively assessed the diagnostic accuracy of another novel method to measure liver stiffness — magnetic resonance elastography — in predicting advanced fibrosis. The method was highly sensitive in predicting stage 3 and 4 fibrosis, so, pending confirmation in a larger cohort, magnetic resonance elastography may be used to noninvasively diagnose advanced fibrosis in patients with fatty liver disease.the information presented here offered new insights into mechanisms of fatty liver disease and perhaps some new directions for diagnosis and management. What is missing, of course, is a reliable and effective treatment approach. This emphasizes the important role of prevention of hepatic steatosis. We must promote healthy eating and consistent physical activity to forestall obesity and its complications.
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