Awareness and opinions of non‐alcoholic fatty liver disease by hospital specialists

Bergqvist, C.-J.; Skoien, Richard; Horsfall, Leigh; Clouston, Andrew D.; Jonsson, Julie R.; Powell, Elizabeth E.

doi:10.1111/j.1445-5994.2012.02848.x

Cited by 63 publications

(72 citation statements)

References 15 publications

(31 reference statements)

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“…This epidemiological trend is mirrored in the emergence of non-alcoholic fatty liver disease (NAFLD) as a major health concern in non-occidental countries, affecting individuals across boundaries for age, sex and ancestral background [5] . Despite growing evidence as to its magnitude and preventability, this "hepatic pandemic" remains largely underdiagnosed and undertreated in routine medical practice [6] . NAFLD encompasses a broad spectrum of hepatic abnormalities and is typified by marked inter-individual heterogeneity in clinical presentation, histological severity, prognosis and therapeutic outcomes.…”

Section: Introductionmentioning

confidence: 99%

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Luckhoff

Kruger

Kotze

2015

WJH

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Heterogeneity in clinical presentation, histological severity, prognosis and therapeutic outcomes charac teristic of nonalcoholic fatty liver disease (NAFLD) necessitates the development of scientifically sound classification schemes to assist clinicians in stratifying patients into meaningful prognostic subgroups. The need for replacement of invasive liver biopsies as the standard method whereby NAFLD is diagnosed, graded and staged with biomarkers of histological severity injury led to the development of composite prognostic models as potentially viable surrogate alternatives. In the present article, we review existing scoring systems used to (1) confirm the presence of undiagnosed hepatosteatosis; (2) distinguish between simple steatosis and NASH; and (3) predict advanced hepatic fibrosis, with particular emphasis on the role of NAFLD as an independent cardiometabolic risk factor. In addition, the incorporation of functional genomic markers and application of emerging imaging technologies are discussed as a means to improve the diagnostic accuracy and predictive performance of promising composite models found to be most appropriate for widespread clinical adoption. Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries have entered the clinical domain as potentially viable alternatives. Lifestylebased intervention remains the cornerstone of treatment in patients with NAFLD. The widespread clinical adoption of composite diagnostic and predictive models could however prove useful in informing clinical and therapeutic decision making with the goal of adding value to patient care across the NAFLD spectrum.Lückhoff HK, Kruger FC, Kotze MJ. Composite prognostic models across the non-alcoholic fatty liver disease spectrum:

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Section: Introductionmentioning

confidence: 99%

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Luckhoff

Kruger

Kotze

2015

WJH

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“…According to an Australian survey, 98% non-liver specialist were able to correctly identify NASH on the basis of LB, while according to study by Ratziu, 38% HepatoGatsroenterologist would not perform this procedure to estimate hepatic inflammation due to its invasive nature. 36,39 LB is still considered the gold standard for the prognosis by majority of physicians. LB is the only means to differentiate NASH from simple steatosis.…”

Section: Liver Biopsymentioning

confidence: 99%

Evidence based literature review of clinical management of non-alcoholic fatty liver disease in real world settings

Choudhuri

Gupta

2017

Int J Basic Clin Pharmacol

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The aim of the present review is to understand the gap between real world clinical practices, guidelines recommendations and to propose minimum essentials that can be followed in clinical practice in NAFLD patients in India. A detailed literature search of published medical reports in English language was performed on electronic databases such as PubMed and Cochrane, from 2000 to 2016 using relevant search terms. The search yielded 25 relevant articles whose full texts were retrieved and evaluated. Non-alcoholic fatty liver disease (NAFLD) is an emerging cause of liver disease in India. It is observed that physicians under appreciate the overlap between NAFLD and metabolic risk factors, thus missing a significant proportion of high-risk NAFLD patients. Lifestyle intervention is generally considered the first line therapy for patients with NAFLD without steatohepatitis while pharmacotherapy (in addition to lifestyle intervention) is suggested for patients with non-alcoholic steatohepatitis (NASH). Current therapies are directed towards improving the metabolic parameters which contribute to disease pathogenesis. Pharmacological therapies for NAFLD and NASH include antioxidants such as vitamin E and ursodeoxycholic acid; insulin sensitizers such as metformin and thiazolidinones, weight loss drugs like orlistat and consideration of bariatric surgery for morbidly obese patients. High degree of suspicion is necessary for diagnosing NAFLD in patients with metabolic risk factors. Further studies are required from India as genotype/clinico-pathological profile of Indian NAFLD patients differ from the western population. Further, prospective studies will fill the various missing links associated with management of NAFLD in Indian patients in a more effective manner.

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“…Many mechanisms underlying the pathogenesis of ALD including direct hepatotoxicity of ethanol and its metabolites, oxidative stress generated by ethanol metabolism, activation of innate immunity, elevation of pro-inflammatory cytokines and chemokines have been identified [35–38]. Regarding the infiltration of leukocytes into inflamed liver tissue, T cells have been described as a major part of the inflammatory response following alcohol-induced liver injury, showing high activity, for example by secreting a variety of inflammatory cytokines such as IL-1β, IL-6, and TNF-α in vitro after isolation [39–43].…”

Section: Il-22 In the Pathogenesis Of Liver Diseasementioning

confidence: 99%

Role of Interleukin-22 in liver diseases

et al. 2014

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IntroductionInterleukin (IL)-22, originally referred to as IL-TIF for IL-10-related T cell-derived inducible factor, is a member of the IL-10-like cytokine family. IL-22 is highly expressed by Th17 cells and is tightly linked to chronic inflammation, including inflammatory bowel disease and local intestinal inflammation among others.Materials and methodsA PubMed and Web of Science databases search was performed for studies providing evidences on the role of IL-22 in liver diseases.ConclusionIL-22 plays an important role in ameliorating liver injury in many rodent models by targeting hepatocytes that express high levels of IL-22 receptor 1 and IL-10 receptor 2. This review concisely summarizes the role of IL-22 in the development progression of liver disease of different etiologies. It is focused mainly on the IL-22 intracellular signaling and its influence on liver diseases.

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Awareness and opinions of non‐alcoholic fatty liver disease by hospital specialists

Cited by 63 publications

References 15 publications

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Evidence based literature review of clinical management of non-alcoholic fatty liver disease in real world settings

Role of Interleukin-22 in liver diseases

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