Non-invasive tests accurately stratify patients with NAFLD based on their risk of liver-related events

Boursier, Jérôme; Hagström, Hannes; Ekstedt, Mattias; Moreau, C; Bonacci, Martín; Cure, S.; Ampuero, Javier; Nasr, Patrik; Tallab, Lilian; Canivet, Clémence M.; Kechagias, Stergios; Sanchez, Yuri; Dincuff, Eloise; Lucena, Ana; Roux, Marine; Riou, Jérémie; Trylesinski, Aldo; Romero–Gómez, Manuel

doi:10.1016/j.jhep.2021.12.031

Cited by 94 publications

(94 citation statements)

References 35 publications

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“…Alpha-fetoprotein levels along with abdomen ultrasound can be used to screen for hepatocellular carcinoma, even though there are no validated surveillance protocols to date [ 37 ]. Liver fibroscan might be an useful and non-invasive tool for the monitoring of the progression of fibrosis/cirrhosis in GSD type IV, VI and IX [ 64 , 87 ].…”

Section: Resultsmentioning

confidence: 99%

Glycogen storage diseases with liver involvement: a literature review of GSD type 0, IV, VI, IX and XI

Massese

Tagliaferri

Dionisi‐Vici

et al. 2022

Orphanet J Rare Dis

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Background Glycogen storage diseases (GSDs) with liver involvement are classified into types 0, I, III, IV, VI, IX and XI, depending on the affected enzyme. Hypoglycemia and hepatomegaly are hallmarks of disease, but muscular and renal tubular involvement, dyslipidemia and osteopenia can develop. Considering the paucity of literature available, herein we provide a narrative review of these latter forms of GSDs. Main body Diagnosis is based on clinical manifestations and laboratory test results, but molecular analysis is often necessary to distinguish the various forms, whose presentation can be similar. Compared to GSD type I and III, which are characterized by a more severe impact on metabolic and glycemic homeostasis, GSD type 0, VI, IX and XI are usually known to be responsive to the nutritional treatment for achieving a balanced metabolic homeostasis in the pediatric age. However, some patients can exhibit a more severe phenotype and an important progression of the liver and muscular disease. The effects of dietary adjustments in GSD type IV are encouraging, but data are limited. Conclusions Early diagnosis allows a good metabolic control, with improvement of quality of life and prognosis, therefore we underline the importance of building a proper knowledge among physicians about these rare conditions. Regular monitoring is necessary to restrain disease progression and complications.

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Section: Resultsmentioning

confidence: 99%

Glycogen storage diseases with liver involvement: a literature review of GSD type 0, IV, VI, IX and XI

Massese

Tagliaferri

Dionisi‐Vici

et al. 2022

Orphanet J Rare Dis

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“…In patients with diabetes, FIB-4 seems to perform better compared with NFS (area under the receiver operating characteristic: 0.78-0.80 vs. 0.72-0.75, respectively) (6,7), and it predicts future cirrhosis well (1). In terms of shortcomings relevant to patient care, NFS tends to overestimate the risk of advanced liver fibrosis in patients with diabetes, whereas FIB-4 underestimates it at a cutoff of 1.3, as shown by Barb et al (2) and confirmed in a recent study (8). Second, although broad unselected population screening may not be cost-effective, we wish to highlight that the presence of cardiometabolic risk factors, hepatic steatosis, elevated alanine transaminase, and, especially, presence of type 2 diabetes greatly increases the risk of future cirrhosis and calls for FIB-4 screening (1).…”

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confidence: 82%

Response to: “Nonalcoholic fatty liver disease in diabetes: Overlooked or just ignored?”

Barb

Cusi

2022

Obesity

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TO THE EDITOR: We wish to thank Williams et al. for their interest in our work and for sharing their screening study in 55 individuals with diabetes attending a secondary care clinic in the UK. The finding that 36% of patients, and as many as 60% of those with diabetes, had clinically significant fibrosis (≥F2) based on a noninvasive test (NIT; either fibrosis-4 [FIB-4] index for liver fibrosis or nonalcoholic fatty liver disease [NAFLD] fibrosis score [NFS]) is of significant interest.This would make a large number of patients with diabetes candidates for additional risk stratification, as suggested by the algorithm recently endorsed by 32 experts in NAFLD across the fields of gastroenterology, hepatology, endocrinology, and primary care (1). The previously stated high prevalence of clinically significant fibrosis is overall higher than in the general population of our study (2) and the overall literature (1), but not when both obesity and type 2 diabetes are present (the highest risk group for advanced liver fibrosis) (2). However,

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“…Hence, widespread systematic NAFLD screening is not still implemented in many countries. Although a FIB-4 cut-off <1.3 is considered to rule out advanced fibrosis in the general population accurately, and thus it is recommended by the latest EASL guidelines on the use of non-invasive tests [ 195 ], Boursier et al recently found that a substantial proportion of diabetic patients with NAFLD and FIB-4 <1.3 who underwent liver biopsy had F3-F4 fibrosis [ 196 ]. Therefore, in diabetic patients with FIB-4 < 1.3 and concomitant factors that might lead to the suspicion of significant or advanced fibrosis (e.g., age, obesity, poor control of DM, elevated transaminases, or other altered non-invasive serologic tests for fibrosis such as ELF), it might be reasonable to perform liver elastography to assess liver stiffness or directly refer the patient to the hepatologist clinic.…”

Section: Algorithm Of Diagnosis and Treatmentmentioning

confidence: 99%

When Sugar Reaches the Liver: Phenotypes of Patients with Diabetes and NAFLD

Rojano-Toimil

Rivera‐Esteban

Manzano-Núñez

et al. 2022

JCM

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Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) have been traditionally linked to one another. Recent studies suggest that NAFLD may be increasingly common in other types of diabetes such as type 1 diabetes (T1DM) and less frequently ketone-prone and Maturity-onset Diabetes of the Young (MODY) diabetes. In this review, we address the relationship between hyperglycemia and insulin resistance and the onset and progression of NAFLD. In addition, despite the high rate of patients with T2DM and other diabetes phenotypes that can alter liver metabolism and consequently develop steatosis, fibrosis, and cirrhosis, NALFD screening is not still implemented in the daily care routine. Incorporating a clinical algorithm created around a simple, non-invasive, cost-effective model would identify high-risk patients. The principle behind managing these patients is to improve insulin resistance and hyperglycemia states with lifestyle changes, weight loss, and new drug therapies.

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Non-invasive tests accurately stratify patients with NAFLD based on their risk of liver-related events

Cited by 94 publications

References 35 publications

Glycogen storage diseases with liver involvement: a literature review of GSD type 0, IV, VI, IX and XI

Glycogen storage diseases with liver involvement: a literature review of GSD type 0, IV, VI, IX and XI

Response to: “Nonalcoholic fatty liver disease in diabetes: Overlooked or just ignored?”

When Sugar Reaches the Liver: Phenotypes of Patients with Diabetes and NAFLD

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