Natural History of Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and an Individualized Approach
Joint Authors
Podrug, Kristian
Madir, Anita
Mikolasevic, Ivana
Grgurevic, Ivica
Kukla, Michał
Tsochatzis, Emmanuel A.
Source
Canadian Journal of Gastroenterology and Hepatology
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-01-21
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract EN
Nonalcoholic fatty liver disease (NAFLD) is becoming the most prevalent liver disease worldwide, associated with epidemics of overweight and resulting metabolic syndrome (MetS).
Around 20–30% of patients with NAFLD develop progressive liver fibrosis, which is the most important predictor of liver-related and overall morbidity and mortality.
In contrast to classical understanding, no significant association has been demonstrated between the inflammatory component of NAFLD, i.e., nonalcoholic steatohepatitis (NASH), and the adverse clinical outcomes.
Older age (>50 years) and presence of type 2 diabetes mellitus, in addition to some genetic variants, are most consistently reported indicators of increased risk of having liver fibrosis.
However, critical driving force for the progression of fibrosis and risk factors for this have still not been fully elucidated.
Apart from the genetic profile, gut dysbiosis, weight gain, worsening of insulin resistance, and worsening of liver steatosis represent candidate factors associated with unfavourable development of liver disease.
Cardiovascular events, extrahepatic malignancies, and liver-related deaths are the leading causes of mortality in NAFLD.
As patients with advanced fibrosis are under highest risk of adverse clinical outcomes, efforts should be made to recognize individuals under risk and rule out the presence of this stage of fibrosis, preferably by using simple noninvasive tools.
This process should start at the primary care level by using validated biochemical tests, followed by direct serum tests for fibrosis or elastography in the remaining patients.
Patients with advanced fibrosis should be referred to hepatologists for aggressive lifestyle modification and correction of the components of MetS, and cirrhotic patients should be screened for hepatocellular carcinoma and oesophageal varices.
American Psychological Association (APA)
Grgurevic, Ivica& Podrug, Kristian& Mikolasevic, Ivana& Kukla, Michał& Madir, Anita& Tsochatzis, Emmanuel A.. 2020. Natural History of Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and an Individualized Approach. Canadian Journal of Gastroenterology and Hepatology،Vol. 2020, no. 2020, pp.1-10.
https://search.emarefa.net/detail/BIM-1139079
Modern Language Association (MLA)
Grgurevic, Ivica…[et al.]. Natural History of Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and an Individualized Approach. Canadian Journal of Gastroenterology and Hepatology No. 2020 (2020), pp.1-10.
https://search.emarefa.net/detail/BIM-1139079
American Medical Association (AMA)
Grgurevic, Ivica& Podrug, Kristian& Mikolasevic, Ivana& Kukla, Michał& Madir, Anita& Tsochatzis, Emmanuel A.. Natural History of Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and an Individualized Approach. Canadian Journal of Gastroenterology and Hepatology. 2020. Vol. 2020, no. 2020, pp.1-10.
https://search.emarefa.net/detail/BIM-1139079
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1139079