A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe

Lazarus, Jeffrey V.; Ekstedt, Mattias; Marchesini, Giulio; Mullen, Jillian; Novak, Katarina; Pericàs, Juan M.; Roel, Elena; Romero‐Gómez, Manuel; Ratziu, Vlad; Tacke, Frank; Cortez‐Pinto, Helena; Anstee, Quentin M.

doi:10.1016/j.jhep.2019.08.027

Cited by 133 publications

(133 citation statements)

References 45 publications

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“…For instance, there are surveys revealing that public awareness of NAFLD was only 2.4%‐3.1% in the United States . Likewise, a most recent study among 29 European countries also revealed a general lack of national policies, awareness, civil societies, and organization for NAFLD …”

Section: Resultsmentioning

confidence: 99%

Epidemiological Features of NAFLD From 1999 to 2018 in China

et al. 2020

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With dramatic changes in lifestyles over the last 20 years, nonalcoholic fatty liver disease (NaFlD) has become the most prevalent liver disorder in China but has not received sufficient attention. NaFlD-related advanced liver disease and its mortality along with its overall disease burden are expected to increase substantially. there is thus an imperative need to clarify the epidemiological features of NaFlD to guide a holistic approach to management. We summarize eight epidemiological features of NaFlD in China over the past two decades using systematic review and meta-analysis methodology. our data reveal a rapid growth in the NaFlD population, especially among younger individuals. Importantly, there is a strong ethnic difference in body mass index (BMI) and genetic risk of NaFlD compared with the US population. the etiology of advanced liver disease and its complications (e.g., hepatocellular carcinoma) has been altered because of a Westernized lifestyle and the implementation of effective vaccination strategies against viral hepatitis. Regional epidemiological patterns of NaFlD indicate that economics, environment, and lifestyle are critical factors in disease progression. the analysis also indicates that a large number of patients remain undiagnosed and untreated because of the inadequacy of diagnostic tools and the absence of effective pharmacologic therapies. given the burden of NaFlD, future policy and research efforts need to address knowledge gaps to mitigate the risk burden.

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Section: Resultsmentioning

confidence: 99%

Epidemiological Features of NAFLD From 1999 to 2018 in China

et al. 2020

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“…For example, in 2018/2019, experts from 29 European countries reported that none of these countries had written strategies or action plans for NAFLD. Only two countries had any mention of NAFLD/NASH in relevant existing strategies such as for obesity 53 . Similarly, while many countries such as Egypt have very effective action plans for viral hepatitis, there are no similar policies to combat the growing burden of MAFLD 54 .…”

Section: Historical Perspective On Fatty Liver Nomenclaturementioning

confidence: 99%

What's in a name? Renaming ‘NAFLD’ to ‘MAFLD’

Fouad

Waked

Bollipo

et al. 2020

Liver International

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In medicine, language matters and the words used to name and describe a disease can have a profound impact on patients and their families. Over the last two decades, many criticisms have been voiced about the nomenclature and definition of non-alcoholic fatty liver disease (NAFLD) in regards not only to the prominent role that alcohol plays in the definition but also on the negative impacts of the nomenclature including trivialization, stigmatization and less consideration of the disease in health policy. Recently, a consensus of international experts proposed that the disease acronym be changed from NAFLD to metabolic (dysfunction) associated fatty liver disease or 'MAFLD'. This change goes far beyond a mere semantic revision and may be the first step that catalyses the process to better conceptualize the disease for health promotion, patient orientation, case identification, ongoing clinical trials and for health services delivery. Here we review the history of, and definitions of MAFLD in the context of advancing our understanding of the pathogenesis of the disease. We also address the reasons, signals, promises, challenges and the way going forward from the name change from various stakeholder perspectives. K E Y W O R D S MAFLD, metabolic, nomenclature | 1255 FOUAD et Al.

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“…A recent survey of the public health response to NAFLD in Europe has highlighted the limited attention to NAFLD in current health care policies and clinical practice guidelines. (26) At a local level, our data highlight the need for a collaborative approach among hepatologists, primary health networks, and health service districts, to better engage PCPs in the use of locally available risk stratification tools and to improve awareness and familiarity with the care of liver disease.…”

Section: Discussionmentioning

confidence: 87%

Nonalcoholic Fatty Liver Disease: Interface Between Primary Care and Hepatology Clinics

et al. 2020

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Primary care physicians (PCPs) have the primary role in the diagnosis and management of nonalcoholic fatty liver disease (NAFLD), and in selecting patients for referral to a hepatologist for further evaluation. This study aimed to characterize PCP referrals for patients diagnosed with NAFLD at a major referral hospital, and to determine the severity of liver disease and patient pathway following evaluation in secondary care. New patients seen in the hepatology outpatient clinic (HOC) with a secondary care diagnosis of NAFLD were identified from the HOC scheduling database. PCP referrals for these patients were retrieved from the electronic medical records and reviewed by study clinicians, along with the hepatologists’ clinic notes and letters. Over a 14‐month period, 234 new PCP referrals received a diagnosis of NAFLD, accounting for 20.4% of the total number of new cases (n = 1,147) seen in the HOC. The 234 referrals were received from 170 individual PCPs at 135 practices. Most patients with NAFLD (88.5%) were referred for investigation of abnormal liver enzymes or other clinical concerns, including abnormal iron studies, hepatomegaly, and abdominal pain. Only 27 (11.5%) referrals included an assessment of liver disease severity. Following evaluation in the liver clinic, 175 patients (74.8%) were found to have a low risk of advanced fibrosis, and most (n = 159; 90.9%) were discharged back to their PCP for ongoing follow‐up in primary care. Conclusion: In addition to better access to noninvasive fibrosis tests, educational strategies to enhance awareness and recognition of NAFLD as a cause for many of the initial concerns prompting patient referral might improve risk stratification and increase the appropriateness of PCP referrals.

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A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe

Cited by 133 publications

References 45 publications

Epidemiological Features of NAFLD From 1999 to 2018 in China

Epidemiological Features of NAFLD From 1999 to 2018 in China

What's in a name? Renaming ‘NAFLD’ to ‘MAFLD’

Nonalcoholic Fatty Liver Disease: Interface Between Primary Care and Hepatology Clinics

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