Comparison between metabolic-associated fatty liver disease and nonalcoholic fatty liver disease: From nomenclature to clinical outcomes

Alomari, Mohammad W.; Rashid, Mamoon Ur; Chadalavada, Pravallika; Ragheb, Jonathan; Zafar, Hammad; Suarez, Zoilo Karim; Khazaaleh, Shrouq; Gonzalez, Adalberto; Castro, Fernando

doi:10.4254/wjh.v15.i4.477

Cited by 3 publications

(3 citation statements)

References 176 publications

(142 reference statements)

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“…Indeed, NAFLD pathophysiology relies on factors contributing to the MS, including weight gain/obesity, insulin resistance, visceral obesity, dyslipidemia, hypertension, and prediabetes or clinically evident diabetes (in which case the name changes into MAFLD; 40 , 41 ), besides physical inactivity, chronic inflammatory conditions, and altered gut microbiota. Clinicians have been looking for a single treatment tool against it for years without success.…”

Section: Discussionmentioning

confidence: 99%

Effect of Neo-Policaptil Gel Retard on Liver Fat Content and Fibrosis in Adults with Metabolic Syndrome and Type 2 Diabetes: A Non-invasive Approach to MAFLD

Guarino,

Strollo,

Della Corte

et al. 2023

Diabetes Ther

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Introduction Non-alcoholic fatty liver disease (NAFLD) is part of a disease spectrum ranging from steatosis to steatohepatitis (NASH), fibrosis, and cirrhosis, and when associated with metabolic syndrome (MS), and overt diabetes is defined as metabolic NAFLD (MAFLD). Some easily available, inexpensive biomarkers have been validated based on common anthropometric and laboratory parameters, including the Fatty Liver Index (FLI), the Fibrosis (FIB)-4 Score (FIB-4), and the NAFLD Fibrosis Score (NFS). In people with overweight/obesity, MS, and diabetes, the pathogenesis of fatty liver involves parameters known to be positively affected by Neo-Policaptil Gel Retard (PGR), a phytocomplex already successfully used in adolescents and adults with MS and type 2 diabetes mellitus (T2DM). This study’s primary outcome was to assess PGR's ability to improve indirect validated signs of liver steatosis and fibrosis, i.e., FLI, FIB-4, and NFS Scores; as the secondary outcome, we aimed to confirm PGR's positive effects on anthropometric parameters and lipid levels and to assess any eventually occurring cytolysis liver marker changes in patients with MS/T2DM and MAFLD/NASH. Methods In this spontaneous, longitudinal, single-blind, randomized clinical study, 245 outpatients with MS/T2DM were enrolled and randomized to PGR or placebo for 24 weeks. All underwent a low-calorie diet (20–25% less than the calories required to maintain current weight) and were encouraged to intensify physical activity. Fat distribution, liver fat content/fibrosis, and biochemical parameters were evaluated at baseline and after 24 weeks. Results Our data show for the first time in adults with MAFLD that, when added to lifestyle changes including a hypocaloric diet and intensified physical activity, PGR improves lipid and glucose metabolism-related parameters, including insulin-resistance, and significantly reduces not only visceral fat but also liver fat content and related liver fibrosis severity. The prevalence of subjects with severe steatosis (FLI > 60) significantly decreased from 95.08 to 47.53% ( p < 0.001) only in the treatment group, which also displayed a significantly decreased prevalence of medium-severe cases (F3–F4) from 83.62% to 52.35% ( p < 0.001) and a markedly increased prevalence of low degree cases (F0–F1) from 9.01 to 42.15% ( p < 0.001). Conclusions The effect of PGR is related to a reduction in the post-meal blood glucose and insulin peaks. As glucose absorption (GA) directly regulates pancreatic insulin release, the attenuated insulin response is likely due to delayed GA with decreased body weight, visceral fat, and cardiovascular risk. Also, an effect on the intestinal microbiota, already documented in the animal model, cannot be excluded, especially considering the reported PGR-related shift from the Firmicutes , notoriou...

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Section: Discussionmentioning

confidence: 99%

Effect of Neo-Policaptil Gel Retard on Liver Fat Content and Fibrosis in Adults with Metabolic Syndrome and Type 2 Diabetes: A Non-invasive Approach to MAFLD

Guarino,

Strollo,

Della Corte

et al. 2023

Diabetes Ther

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“…Nonalcoholic fatty liver disease (NAFLD) is a metabolic dysfunction of the liver characterized by excessive fat accumulation in the liver tissue. It is defined by the presence of lipid droplets (steatosis) in more than 5% of hepatocytes in the absence of other etiologies of liver disease [1,2]. NAFLD is the most common chronic liver disease, affecting around 25% of the world's population.…”

Section: Introductionmentioning

confidence: 99%

“…It has been recognized as a hepatic manifestation of the metabolic syndrome associated with overweight, obesity, and insulin resistance. Recently, a new term, metabolic (dysfunction)-associated fatty liver disease (MAFLD), was suggested, emphasizing the important role of metabolic dysfunction in its pathogenesis [2]. NAFLD can progress to nonalcoholic steatohepatitis (NASH), an inflammatory condition associated with liver fibrosis [1], and eventually progress to cirrhosis associated with portal hypertension, end-stage liver disease requiring liver transplantation, or hepatocellular carcinoma [3].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Adjuvant Therapy with Molecular Hydrogen on Endogenous Coenzyme Q10 Levels and Platelet Mitochondrial Bioenergetics in Patients with Non-Alcoholic Fatty Liver Disease

Sumbalová,

Kucharská,

Rausová

et al. 2023

IJMS

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Molecular hydrogen (H2) has been recognized as a novel medical gas with antioxidant and anti-inflammatory effects. Non-alcoholic fatty liver disease (NAFLD) is a liver pathology with increased fat accumulation in liver tissue caused by factors other than alcohol consumption. Platelet mitochondrial function is considered to reflect systemic mitochondrial health. We studied the effect of adjuvant therapy with hydrogen-rich water (HRW) on coenzyme Q10 (CoQ10) content and platelet mitochondrial bioenergetics in patients with NAFLD. A total of 30 patients with NAFLD and 15 healthy volunteers were included in this clinical trial. A total of 17 patients (H2 group) drank water three × 330 mL/day with tablets producing HRW (>4 mg/L H2) for 8 weeks, and 13 patients (P group) drank water with placebo tablets producing CO2. The concentration of CoQ10-TOTAL was determined by the HPLC method, the parameter of oxidative stress, thiobarbituric acid reactive substances (TBARS), by the spectrophotometric method, and mitochondrial bioenergetics in platelets isolated from whole blood by high-resolution respirometry. The patients with NAFLD had lower concentrations of CoQ10-TOTAL in the blood, plasma, and platelets vs. the control group. Mitochondrial CI-linked LEAK respiration was higher, and CI-linked oxidative phosphorylation (OXPHOS) and CII-linked electron transfer (ET) capacities were lower vs. the control group. Plasma TBARS concentrations were higher in the H2 group. After 8 weeks of adjuvant therapy with HRW, the concentration of CoQ10 in platelets increased, plasma TBARS decreased, and the efficiency of OXPHOS improved, while in the P group, the changes were non-significant. Long-term supplementation with HRW could be a promising strategy for the acceleration of health recovery in patients with NAFLD. The application of H2 appears to be a new treatment strategy for targeted therapy of mitochondrial disorders. Additional and longer-term studies are needed to confirm and elucidate the exact mechanisms of the mitochondria-targeted effects of H2 therapy in patients with NAFLD.

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Changes in the terminology and diagnostic criteria of non-alcoholic fatty liver disease: Implications and opportunities

Mubarak

2024

World J Gastrointest Pathophysiol

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Fatty liver disease (FLD) is a highly prevalent pathological liver disorder. It has many and varied etiologies and has heterogeneous clinical course and outcome. Its proper nomenclature and classification have been problematic since its initial recognition. Traditionally, it was divided into two main categories: Alcohol-associated liver disease and nonalcoholic FLD (NAFLD). Among these, the latter condition has been plagued with nomenclature and classification issues. The two main objections to its use have been the use of negative (non-alcoholic) and stigmatizing (fatty) terms in its nomenclature. Numerous attempts were made to address these issues but none achieved universal acceptance. Just recently, NAFLD has received a new nomenclature from an international collaborative effort based on a rigorous scientific methodology. FLD has been renamed steatotic liver disease (SLD), and NAFLD as metabolic dysfunction-associated SLD. Metabolic dysfunction-associated steatohepatitis was chosen as the replacement terminology for non-alcoholic steatohepatitis. This is a significant positive change in the nomenclature and categorization of FLD and will likely have a major impact on research, diagnosis, treatment, and prognosis of the disease in the future.

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Comparison between metabolic-associated fatty liver disease and nonalcoholic fatty liver disease: From nomenclature to clinical outcomes

Cited by 3 publications

References 176 publications

Effect of Neo-Policaptil Gel Retard on Liver Fat Content and Fibrosis in Adults with Metabolic Syndrome and Type 2 Diabetes: A Non-invasive Approach to MAFLD

Effect of Neo-Policaptil Gel Retard on Liver Fat Content and Fibrosis in Adults with Metabolic Syndrome and Type 2 Diabetes: A Non-invasive Approach to MAFLD

The Effect of Adjuvant Therapy with Molecular Hydrogen on Endogenous Coenzyme Q10 Levels and Platelet Mitochondrial Bioenergetics in Patients with Non-Alcoholic Fatty Liver Disease

Changes in the terminology and diagnostic criteria of non-alcoholic fatty liver disease: Implications and opportunities

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