Epidemiology of non‐alcoholic fatty liver disease‐related hepatocellular carcinoma and its implications

Wong, Sui‐Weng; Ting, Yi-Wen; Chan, Wah‐Kheong

doi:10.1002/jgh3.12070

Cited by 54 publications

(54 citation statements)

References 57 publications

(141 reference statements)

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“…47 Moreover, patients with NAFLD-related HCC had a shorter survival time, more cardiovascular events, and more cancer-related mortality than patients without NAFLD. 48 In a study from Germany, where 1119 patients with HCC treated in an 11 year period were retrospectively analyzed, the overall survival among the patients with NASH-related HCC (n = 45) was lower compared to those with HCC of other etiologies. 49 However, it appears that the worse natural history in such patients is not related to a more aggressive behavior of NAFLD -HCC, but mainly to detection at a later stage.…”

Section: Nafld and Hccmentioning

confidence: 99%

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Kumar¹,

Priyadarshi²,

Anand³

2019

Journal of Clinical and Translational Hepatology

115

123

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Nonalcoholic fatty liver disease (NAFLD) is a systemic disorder with a complex multifactorial pathogenesis and heterogenous clinical manifestations. NAFLD, once believed to be an innocuous condition, has now become the most common cause of chronic liver disease in many countries worldwide. NAFLD is already highly prevalent in the general population, and owing to a rising incidence of obesity and diabetes mellitus, the incidence of NAFLD and its impact on global healthcare are expected to increase in the future. A subset of patients with NAFLD develops progressive liver disease leading to cirrhosis, hepatocellular carcinoma, and liver failure. NAFLD has emerged as one of the leading causes of cirrhosis and hepatocellular carcinoma in recent years. Moreover, HCC can occur in NAFLD even in absence of cirrhosis. Compared with the general population, NAFLD increases the risk of liverrelated, cardiovascular and all-cause mortality. NAFLD is bidirectionally associated with metabolic syndrome. NAFLD increases the risk and contributes to aggravation of the pathophysiology of atherosclerosis, cardiovascular diseases, diabetes mellitus, and chronic kidney disease. In addition, NAFLD is linked to colorectal polyps, polycystic ovarian syndrome, osteoporosis, obstructive sleep apnea, stroke, and various extrahepatic malignancies. Extended resection of steatotic liver is associated with increased risk of liver failure and mortality. There is an increasing trend of NAFLDrelated cirrhosis requiring liver transplantation, and the recurrence of NAFLD in such patients is almost universal. This review discusses the growing burden of NAFLD, its outcomes, and adverse associations with various diseases. Citation of this article: Kumar R, Priyadarshi RN, Anand U. Non-alcoholic fatty liver disease: Growing burden, adverse outcomes and associations. Global burden and rising prevalenceAccording to current estimate, the global prevalence of NAFLD among the general population may be as high as one billion. 2 In a recent meta-analysis of 86 studies, 76

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Section: Nafld and Hccmentioning

confidence: 99%

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Kumar¹,

Priyadarshi²,

Anand³

2019

Journal of Clinical and Translational Hepatology

115

123

View full text Add to dashboard Cite

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“…Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder in the United States, potentially leading to fibrosis, cirrhosis, and hepatocellular carcinoma progress [1][2][3][4]. NAFLD is manifested with a wide spectrum of clinical symptoms while disease pathogenesis is described through a "multiple-hit model."…”

Section: Introductionmentioning

confidence: 99%

Plasma Krebs Cycle Intermediates in Nonalcoholic Fatty Liver Disease

Sandlers

Shah

Pearce

et al. 2020

JCM

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Nonalcoholic liver disease (NAFLD) is manifested with a wide spectrum of clinical symptoms and is closely associated with the metabolic syndrome, inflammation, and mitochondrial dysfunction. Although the mechanism of mitochondrial dysfunction in NAFLD is still not fully elucidated, multiple studies have demonstrated evidence of molecular, biochemical, and biophysical mitochondrial abnormalities in NAFLD. Given the association between NAFLD and mitochondrial dysfunction, the aim of this study is to analyze circulating levels of Krebs cycle intermediates in a cohort of NAFLD-affected individuals and matching healthy controls and to correlate our findings with the liver function metrics. Standard serum biochemistry and Krebs cycle intermediates were analyzed in NAFLD (n = 22) and matched control (n = 67) cohorts. Circulating levels of isocitrate and citrate were significantly (p < 0.05) elevated in the NAFLD cohort of patients. The area under the curve (AUROC) for these two metabolites exhibited a moderate clinical utility. Correlations between plasma Krebs cycle intermediates and standard clinical plasma metrics were explored by Pearson’s correlation coefficient. The data obtained for plasma Krebs cycle intermediates suggest pathophysiological insights that link mitochondrial dysfunction with NAFLD. Our findings reveal that plasma isocitrate and citrate can discriminate between normal and NAFLD cohorts and can be utilized as noninvasive markers of mitochondrial dysfunction in NAFLD. Future studies with large populations at different NAFLD stages are warranted.

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“…1 Nonalcoholic steatohepatitis (NASH) is the more severe form of NAFLD that is defined histologically by the presence of lobular inflammation and hepatocyte ballooning that can lead to fibrosis and cirrhosis with increased risk of developing hepatocellular carcinoma (HCC). 2,3 NAFLD is closely associated with the metabolic syndrome, which includes central obesity, impaired fasting glucose, impaired glucose tolerance or frank diabetes mellitus, arterial hypertension, and atherogenic dyslipidemia. 4 Consequently, NAFLD patients are at increased risk of cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

Suboptimal treatment of dyslipidemia in patients with nonalcoholic fatty liver disease

Khoo

Wong

Goh

et al. 2019

J of Gastro and Hepatol

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Background and Aim Nonalcoholic fatty liver disease (NAFLD) patients often have dyslipidemia, and optimal treatment of dyslipidemia lowers the risk of cardiovascular disease and mortality. Our aim was to study the prescription of statin and low‐density lipoprotein cholesterol treatment targets in NAFLD patients. Methods Consecutive NAFLD patients attending five clinics in Asia were included in this study. The 10‐year cardiovascular disease risk was calculated based on the Framingham Heart Study, and patients were categorized as moderate, high, or very high risk for cardiovascular disease on the basis of the American Association of Clinical Endocrinologist 2017 Guidelines. The low‐density lipoprotein cholesterol treatment goal for each of the risk groups was 2.6, 2.6, and 1.8 mmol/L, respectively. Results The data for 428 patients were analyzed (mean age 54.4 ± 11.1 years, 52.1% male). Dyslipidemia was seen in 60.5% (259/428), but only 43.2% (185/428) were on a statin. The percentage of patients who were at moderate, high, and very high risk for cardiovascular disease was 36.7% (157/428), 27.3% (117/428), and 36.0% (154/428), respectively. Among patients who were on a statin, 58.9% (109/185) did not achieve the treatment target. Among patients who were not on a statin, 74.1% (180/243) should be receiving statin therapy. The percentage of patients who were not treated to target or who should be on statin was highest among patients at very high risk for cardiovascular disease at 79.6% (78/98) or 94.6% (53/56), respectively. Conclusion This study highlights the suboptimal treatment of dyslipidemia and calls for action to improve the treatment of dyslipidemia in NAFLD patients.

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Epidemiology of non‐alcoholic fatty liver disease‐related hepatocellular carcinoma and its implications

Cited by 54 publications

References 57 publications

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Plasma Krebs Cycle Intermediates in Nonalcoholic Fatty Liver Disease

Suboptimal treatment of dyslipidemia in patients with nonalcoholic fatty liver disease

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