The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases.

doi:10.1002/HEP.29367

Home
/
Papers
/
The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases.

Journal Article•DOI•

The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases.

Naga Chalasani¹, Zobair M. Younossi², Joel E. Lavine³, Michael Charlton⁴, Kenneth Cusi⁵, Mary E. Rinella⁶, Stephen A. Harrison⁷, Elizabeth M. Brunt⁸, Arun J. Sanyal⁹ - Show less +5 more•Institutions (9)

Indiana University¹, Inova Fairfax Hospital², Columbia University³, University of Chicago⁴, University of Florida⁵, Northwestern University⁶, Pinnacle Financial Partners⁷, Washington University in St. Louis⁸, Virginia Commonwealth University⁹

01 Jan 2018-Hepatology (John Wiley & Sons, Ltd)-Vol. 67, Iss: 1, pp 328-357

TL;DR: This guidance provides a data-supported approach to the diagnostic, therapeutic, and preventive aspects of NAFLD care.

read less

About: This article is published in Hepatology.The article was published on 2018-01-01 and is currently open access. It has received 4431 citations till now. The article focuses on the topics: Guideline.

...read moreread less

Citations

PDF

Open Access

More filters

Journal Article•DOI•

A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement.

[...]

Mohammed Eslam¹, Philip N. Newsome², Shiv Kumar Sarin, Quentin M. Anstee³, Giovanni Targher, Manuel Romero-Gómez⁴, Shira Zelber-Sagi⁵, Vincent Wai-Sun Wong⁶, Jean-François Dufour⁷, Jörn M. Schattenberg⁸, Takumi Kawaguchi⁹, Marco Arrese¹⁰, Luca Valenti¹¹, Gamal Shiha¹², Claudio Tiribelli, Hannele Yki-Järvinen¹³, Jian-Gao Fan¹⁴, Henning Grønbæk¹⁵, Yusuf Yilmaz¹⁶, Helena Cortez-Pinto¹⁷, Claudia P. Oliveira¹⁸, Pierre Bedossa¹⁹, Leon A. Adams²⁰, Ming-Hua Zheng²¹, Yasser Fouad²², Wah-Kheong Chan²³, Nahum Méndez-Sánchez²⁴, Sang Hoon Ahn²⁵, Laurent Castera²⁶, Elisabetta Bugianesi²⁷, Vlad Ratziu²⁶, Jacob George¹ - Show less +28 more•Institutions (27)

University of Sydney¹, University Hospitals Birmingham NHS Foundation Trust², Newcastle upon Tyne Hospitals NHS Foundation Trust³, Spanish National Research Council⁴, University of Haifa⁵, The Chinese University of Hong Kong⁶, University of Bern⁷, University of Mainz⁸, Kurume University⁹, Pontifical Catholic University of Chile¹⁰, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico¹¹, Mansoura University¹², Minerva Foundation Institute for Medical Research¹³, Shanghai Jiao Tong University¹⁴, Aarhus University Hospital¹⁵, Marmara University¹⁶, University of Lisbon¹⁷, University of São Paulo¹⁸, Paris Diderot University¹⁹, University of Western Australia²⁰, First Affiliated Hospital of Wenzhou Medical University²¹, Minia University²², University of Malaya²³, National Autonomous University of Mexico²⁴, Yonsei University²⁵, University of Paris²⁶, University of Turin²⁷

01 Jul 2020-Journal of Hepatology

TL;DR: A panel of international experts from 22 countries propose a new definition of metabolic-dysfunction-associated fatty liver disease that is both comprehensive yet simple for the diagnosis of MAFLD and is independent of other liver diseases.

...read moreread less

1,705 citations

Journal Article•DOI•

MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease.

[...]

Mohammed Eslam¹, Arun J. Sanyal², Jacob George¹•Institutions (2)

University of Sydney¹, Virginia Commonwealth University²

01 May 2020-Gastroenterology

TL;DR: Experts reached consensus that NAFLD does not reflect current knowledge and metabolic (dysfunction) associated fatty liver disease "MAFLD" was suggested as a more appropriate overarching term and opens the door for efforts from the research community to update the nomenclature and sub-phenotype the disease in order to accelerate the translational path to new treatments.

...read moreread less

1,544 citations

Journal Article•DOI•

Non-alcoholic fatty liver disease - A global public health perspective.

[...]

Zobair M. Younossi¹, Zobair M. Younossi²•Institutions (2)

Inova Health System¹, Inova Fairfax Hospital²

01 Mar 2019-Journal of Hepatology

TL;DR: Given the rapidly growing global burden of NAFLD and NASH, efforts must continue to find accurate non-invasive diagnostic and prognostic biomarkers, to develop effective treatments for individuals with advanced NASH and prevention methods for individuals at high risk of NA FLD and progressive liver disease.

...read moreread less

1,173 citations

Journal Article•DOI•

The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis.

[...]

Zobair M. Younossi¹, Zobair M. Younossi², Pegah Golabi¹, Leyla de Avila¹, James Paik¹, Manirath K. Srishord¹, Natsu Fukui², Ying Qiu³, Leah Burns³, Arian Afendy, Fatema Nader - Show less +7 more•Institutions (3)

Inova Health System¹, Inova Fairfax Hospital², Bristol-Myers Squibb³

01 Oct 2019-Journal of Hepatology

TL;DR: Evidence is provided supporting high prevalence of NAFLD and NASH in patients with T2DM around the world and regional and global mean prevalence weighted by population size in each country were estimated and pooled using random-effects meta-analysis.

...read moreread less

1,032 citations

Journal Article•DOI•

Global Perspectives on Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis

[...]

Zobair M. Younossi¹, Zobair M. Younossi², Frank Tacke³, Marco Arrese⁴, Barjesh Chander Sharma, Ibrahim Mostafa⁵, Elisabetta Bugianesi⁶, Vincent Wai-Sun Wong⁷, Yusuf Yilmaz⁸, Jacob George⁹, Jian-Gao Fan¹⁰, Miriam B. Vos¹¹ - Show less +8 more•Institutions (11)

Inova Fairfax Hospital¹, Inova Health System², RWTH Aachen University³, Pontifical Catholic University of Chile⁴, Theodor Bilharz Research Institute⁵, University of Turin⁶, The Chinese University of Hong Kong⁷, Marmara University⁸, University of Sydney⁹, Shanghai Jiao Tong University¹⁰, Emory University¹¹

01 Jun 2019-Hepatology

TL;DR: The authors in this article examined the state of NAFLD among different regions and understand the global trajectory of this disease, an international group of experts came together during the 2017 American Association for the Study of Liver Diseases Global NASFLD Forum and provided a summary of this forum and an assessment of the current state of NASH worldwide.

...read moreread less

978 citations

1
2
3
4
…
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200

Collapse

References

PDF

Open Access

More filters

Journal Article•DOI•

GRADE: an emerging consensus on rating quality of evidence and strength of recommendations

[...]

Gordon H. Guyatt¹, Andrew D Oxman, Gunn Elisabeth Vist, Regina Kunz², Yngve Falck-Ytter³, Pablo Alonso-Coello⁴, Holger J. Schünemann - Show less +3 more•Institutions (4)

McMaster University¹, University Hospital of Basel², Case Western Reserve University³, Autonomous University of Barcelona⁴

24 Apr 2008-BMJ

TL;DR: The advantages of the GRADE system are explored, which is increasingly being adopted by organisations worldwide and which is often praised for its high level of consistency.

...read moreread less

Abstract: Guidelines are inconsistent in how they rate the quality of evidence and the strength of recommendations. This article explores the advantages of the GRADE system, which is increasingly being adopted by organisations worldwide

...read moreread less

13,324 citations

"The diagnosis and management of non..." refers background or methods in this paper

...*The Adult Treatment Panel III clinical definition of MetS requires the presence of three or more of the following features: (1) waist circumference greater than 102 cm in men or greater than 88 cm in women; (2) TG level 150 mg/dL or greater; (3) HDL cholesterol level less than 40 mg/dL in men and less than 50 mg/dL in women; (4) systolic blood pressure 130 mm Hg or greater or diastolic pressure 85 mm Hg or greater; and (5) fasting plasma glucose level 110 mg/dL or greater....
[...]
...This narrative review and guidance statements are based on the following: (1) a formal review and analysis of the recently published world literature on the topic (Medline search up to August 2016); (2) the American College of Physicians’ Manual for Assessing Health Practices and Designing Practice Guidelines((2)); (3) guideline policies of the AASLD; and (4) the experience of the authors and independent reviewers with regard to NAFLD....
[...]
...The diagnosis of NAFLD requires that (1) there is HS by imaging or histology, (2) there is no significant alcohol consumption, (3) there are no competing etiologies for HS, and (4) there are no coexisting causes of CLD....
[...]
...Specific guidance statements are evidence based whenever possible, and, when such evidence is not available or is inconsistent, guidance statements are made based on the consensus opinion of the authors.((3)) This is a practice guidance for clinicians rather than a review article, and interested readers can refer to several recent comprehensive reviews....
[...]
...Despite these limitations, it can be summarized that (1) the use of vitamin E is associated with a decrease in aminotransferases in subjects with NASH, (2) studies in which histological endpoints were evaluated indicate that vitamin E results in improvement in steatosis, inflammation, and ballooning and resolution of SH in a proportion of nondiabetic adults with NASH, and (3) vitamin E did not have an effect on HF....
[...]

Journal Article•DOI•

Diagnosis and Management of the Metabolic Syndrome An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement

[...]

Scott M. Grundy, James I. Cleeman, Stephen R. Daniels, Karen A. Donato, Robert H. Eckel, Barry A. Franklin, David Gordon, Ronald M. Krauss, Peter J. Savage, Sidney C. Smith, John A. Spertus, Fernando Costa - Show less +8 more

25 Oct 2005-Circulation

TL;DR: This statement from the American Heart Association and the National Heart, Lung, and Blood Institute is intended to provide up-to-date guidance for professionals on the diagnosis and management of the metabolic syndrome in adults.

...read moreread less

Abstract: The metabolic syndrome has received increased attention in the past few years. This statement from the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) is intended to provide up-to-date guidance for professionals on the diagnosis and management of the metabolic syndrome in adults. The metabolic syndrome is a constellation of interrelated risk factors of metabolic origin— metabolic risk factors —that appear to directly promote the development of atherosclerotic cardiovascular disease (ASCVD).1 Patients with the metabolic syndrome also are at increased risk for developing type 2 diabetes mellitus. Another set of conditions, the underlying risk factors , give rise to the metabolic risk factors. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria to be used in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general they include a combination of both underlying and metabolic risk factors. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics commonly manifest a prothrombotic state and a pro-inflammatory state as well. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB), increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C). The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it truly is a syndrome, ie, a grouping of ASCVD risk factors, but one that probably has more than one cause. Regardless of cause, the syndrome identifies individuals at an elevated risk for ASCVD. The magnitude of the increased risk can vary according to which components of the syndrome are …

...read moreread less

9,982 citations

Journal Article•DOI•

Design and validation of a histological scoring system for nonalcoholic fatty liver disease

[...]

David E. Kleiner¹, Elizabeth M. Brunt², Mark L. Van Natta³, Cynthia Behling⁴, Melissa J. Contos⁵, Oscar W. Cummings, Linda D. Ferrell⁶, Yao Chang Liu⁷, Michael Torbenson³, Aynur Unalp-Arida³, Matthew M. Yeh⁸, Arthur J. McCullough⁷, Arun J. Sanyal⁹ - Show less +9 more•Institutions (9)

National Institutes of Health¹, Saint Louis University², Johns Hopkins University³, University of California, San Diego⁴, Virginia Commonwealth University⁵, University of California, San Francisco⁶, MetroHealth⁷, University of Washington Medical Center⁸, VCU Medical Center⁹

01 Jun 2005-Hepatology

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.

...read moreread less

8,253 citations

"The diagnosis and management of non..." refers methods in this paper

...Specific scoring systems such as NAS((128)) and/or SAF((128,129)) may be used as deemed appropriate....
[...]
...There are two systems for semiquantitative assessment of necroinflammatory lesions in NAFLD: NAFLD Activity Score (NAS) from the NASH CRN((128)) and Steatosis Activity Fibrosis (SAF) from the European Fatty Liver Inhibition of Progression Consortium....
[...]

Journal Article•DOI•

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 - Show less +12 more

24 Jun 2014-Circulation

TL;DR: Preamble and Transition to ACC/AHA Guidelines to Reduce Cardiovascular Risk S2 The goals of the …

...read moreread less

Abstract: Preamble and Transition to ACC/AHA Guidelines to Reduce Cardiovascular Risk S2 The goals of the …

...read moreread less

7,184 citations

Journal Article•DOI•

Global epidemiology of nonalcoholic fatty liver disease—Meta‐analytic assessment of prevalence, incidence, and outcomes

[...]

Zobair M. Younossi¹, Zobair M. Younossi², Aaron B. Koenig¹, Dinan Abdelatif¹, Yousef Fazel¹, Linda Henry, Mark Wymer², Mark Wymer¹ - Show less +4 more•Institutions (2)

Inova Health System¹, Inova Fairfax Hospital²

01 Jul 2016-Hepatology

TL;DR: As the global epidemic of obesity fuels metabolic conditions, the clinical and economic burden of NAFLD will become enormous, and random‐effects models were used to provide point estimates of prevalence, incidence, mortality and incidence rate ratios.

...read moreread less

6,746 citations

"The diagnosis and management of non..." refers background in this paper

...56), respectively.((16)) The most important histological feature of NAFLD associated with long-term mortality is fibrosis; specifically, zone 3 sinusoidal fibrosis plus periportal fibrosis (stage 2) to advanced (bridging fibrosis [stage 3] or cirrhosis [stage 4])....
[...]
...12).((16)) Given these estimates, one estimates that the prevalence of NASH in the general population ranges between 1....
[...]
...Features of metabolic syndrome (MetS) are not only highly prevalent in patients with NAFLD, but components of MetS also increase the risk of developing NAFLD.((16,18-20)) This bidirectional association between NAFLD and components of MetS has been strongly established....
[...]
...12).((16)) Several studies investigated the natural history of NASH cirrhosis in comparison to patients with hepatitis C cirrhosis....
[...]
...66) per 1,000 person-years.((16)) In another study of patients with HCC, 54....
[...]