Journal ArticleDOI
Nonalcoholic Fatty Liver Disease: A Systematic Review
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TLDR
How to identify patients with nonalcoholic fatty liver disease at greatest risk of non Alcoholic steatohepatitis and cirrhosis is illustrated and the role and limitations of current diagnostics and liver biopsy are discussed to provide an outline for the management of patients across the spectrum of non alcoholic fatty Liver disease.Abstract:
Importance Nonalcoholic fatty liver disease and its subtype nonalcoholic steatohepatitis affect approximately 30% and 5%, respectively, of the US population. In patients with nonalcoholic steatohepatitis, half of deaths are due to cardiovascular disease and malignancy, yet awareness of this remains low. Cirrhosis, the third leading cause of death in patients with nonalcoholic fatty liver disease, is predicted to become the most common indication for liver transplantation. Objectives To illustrate how to identify patients with nonalcoholic fatty liver disease at greatest risk of nonalcoholic steatohepatitis and cirrhosis; to discuss the role and limitations of current diagnostics and liver biopsy to diagnose nonalcoholic steatohepatitis; and to provide an outline for the management of patients across the spectrum of nonalcoholic fatty liver disease. Evidence Review PubMed was queried for published articles through February 28, 2015, using the search termsNAFLD and cirrhosis, mortality, biomarkers,andtreatment. A total of 88 references were selected, including 14 randomized clinical trials, 19 cohort or case-control studies, 1 population-based study, 2 practice guidelines, 7 meta-analyses, 43 classified as other, and 2 webpages. Findings Sixty-six percent of patients older than 50 years with diabetes or obesity are thought to have nonalcoholic steatohepatitis with advanced fibrosis. Even though the ability to identify the nonalcoholic steatohepatitis subtype within those with nonalcoholic fatty liver disease still requires liver biopsy, biomarkers to detect advanced fibrosis are increasingly reliable. Lifestyle modification is the foundation of treatment for patients with nonalcoholic steatosis. Available treatments with proven benefit include vitamin E, pioglitazone, and obeticholic acid; however, the effect size is modest ( Conclusions and Relevance Between 75 million and 100 million individuals in the United States are estimated to have nonalcoholic fatty liver disease and its potential morbidity extends beyond the liver. It is important that primary care physicians, endocrinologists, and other specialists be aware of the scope and long-term effects of the disease. Early identification of patients with nonalcoholic steatohepatitis may help improve patient outcomes through treatment intervention, including transplantation for those with decompensated cirrhosis.read more
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Asia–Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update
Masao Omata,Ann-Lii Cheng,Norihiro Kokudo,Masatoshi Kudo,Jeong Min Lee,Jidong Jia,Ryosuke Tateishi,Kwang Hyub Han,Yoghesh K. Chawla,Shuichiro Shiina,Wasim Jafri,Diana A. Payawal,Takamasa Ohki,Sadahisa Ogasawara,Pei-Jer Chen,Cosmas Rinaldi Adithya Lesmana,Laurentius A. Lesmana,Rino Alvani Gani,Shuntaro Obi,A. Kadir Dokmeci,Shiv Kumar Sarin +20 more
TL;DR: The latest guidelines for the treatment of HCC recommend evidence-based management and are considered suitable for universal use in the Asia–Pacific region, which has a diversity of medical environments.
Journal ArticleDOI
Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease
TL;DR: With continued high rates of adult obesity and DM along with an aging population, NAFLD‐related liver disease and mortality will increase in the United States and strategies to slow the growth ofNAFLD cases and therapeutic options are necessary to mitigate disease burden.
Journal ArticleDOI
Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: Systematic review and meta-analysis.
Parambir S. Dulai,Siddharth Singh,Janki Patel,Meera Soni,Larry J. Prokop,Zobair M. Younossi,Giada Sebastiani,Mattias Ekstedt,Hannes Hagström,Patrik Nasr,Per Stål,Vincent Wai-Sun Wong,Stergios Kechagias,Rolf Hultcrantz,Rohit Loomba +14 more
TL;DR: The risk of liver‐related mortality increases exponentially with increase in fibrosis stage; these data have important implications in assessing the utility of each stage and benefits of regression of fibrosis from one stage to another.
Journal ArticleDOI
Modeling NAFLD Disease Burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030
Chris Estes,Quentin M. Anstee,María Teresa Arias-Loste,Heike Bantel,Stefano Bellentani,Joan Caballería,Massimo Colombo,Antonio Craxì,Javier Crespo,Christopher P. Day,Yuichiro Eguchi,Andreas Geier,Loreta A. Kondili,Daniela C. Kroy,Jeffrey V. Lazarus,Rohit Loomba,Michael P. Manns,Giulio Marchesini,Atsushi Nakajima,Francesco Negro,Salvatore Petta,V. Ratziu,Manuel Romero-Gómez,Arun J. Sanyal,Jörn M. Schattenberg,Frank Tacke,Junko Tanaka,Christian Trautwein,Lai Wei,Stefan Zeuzem,Homie Razavi +30 more
TL;DR: NAFLD and NASH represent a large and growing public health problem and efforts to understand this epidemic and to mitigate the disease burden are needed, if obesity and DM continue to increase at current and historical rates.
Journal ArticleDOI
Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: A meta-analysis
TL;DR: Clinicians who manage patients with NAFLD should not focus only on liver disease but should also consider the increased risk of cardiovascular disease and undertake early, aggressive risk factor modification.
References
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Journal ArticleDOI
Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)
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TL;DR: Dairy therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD, and the fundamental approach to treatment is comparable.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Detection, Evaluation, and Treatment of High Blood Cholesterol Education Program (NCEP) Expert Panel on Executive Summary of the Third Report of the National
William C. Taylor,Nigel Unwin +1 more
Journal Article
Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)
Scott M. Grundy,Diane M. Becker,Luther T. Clark,Richard S. Cooper,Margo A. Denke,James P. Howard,Donald B. Hunninghake,D. Roger Illingworth,Russell V. Luepker,Patrick E. McBride,James M. McKenney,Richard C. Pasternak,Neil J. Stone,Linda Van Horn +13 more
Journal ArticleDOI
Design and validation of a histological scoring system for nonalcoholic fatty liver disease
David E. Kleiner,Elizabeth M. Brunt,Mark L. Van Natta,Cynthia Behling,Melissa J. Contos,Oscar W. Cummings,Linda D. Ferrell,Yao Chang Liu,Michael Torbenson,Aynur Unalp-Arida,Matthew M. Yeh,Arthur J. McCullough,Arun J. Sanyal +12 more
TL;DR: A strong scoring system and NAS for NAFLD and NASH with reasonable inter‐rater reproducibility that should be useful for studies of both adults and children with any degree ofNAFLD are presented.
Journal ArticleDOI
2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
Neil J. Stone,Jennifer G. Robinson,Alice H. Lichtenstein,C. Noel Bairey Merz,Conrad B. Blum,Robert H. Eckel,Anne C. Goldberg,David Lee Gordon,Daniel Levy,Donald M. Lloyd-Jones,Patrick E. McBride,J. Sanford Schwartz,Susan T. Shero,Sidney C. Smith,Karol E. Watson,Peter W.F. Wilson +15 more
TL;DR: Preamble and Transition to ACC/AHA Guidelines to Reduce Cardiovascular Risk S2 The goals of the …