Nonalcoholic fatty liver disease in Brazil. Clinical and histological profile

Cotrim, Helma Pinchemel; Parise, Edison Roberto; Oliveira, Cláudia Pinto Marques Souza de; Leite, Natalhie; Martinelli, Ana de Lôurdes Candolo; Galizzi, J; Silva, Rita de Càssia; Mattos, Angelo A.; Pereira, Leila Maria Moreira Beltrão; Amorim, Welma Wildes; Ivantes, Claudia Alexandra Pontes; Souza, Francisco Ferreira de; Costa, Marcelo Abrahão; Maia, L.; Pessôa, Mário; Oliveira, F.R.

doi:10.1016/s1665-2681(19)31584-4

Cited by 59 publications

(41 citation statements)

References 18 publications

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“…The results of sensitivity and specificity for steatohepatitis are low [14,34,35]. Using conservative cutoff rates of 19 IU/L for women and 30 IU/L for men [36], the sensitivity and specificity for diagnosing steatohepatitis were 99 and 8 %, respectively. In common practice, where the upper limit is set to 40 IU/L, the sensitivity and specificity for diagnosing steatohepatitis were 86 and 32 %, respectively [34].…”

Section: Discussionmentioning

confidence: 94%

Prevalence of Non-alcoholic Fatty Liver Disease and Steatohepatitis Risk Factors in Patients Undergoing Bariatric Surgery

et al. 2015

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Section: Discussionmentioning

confidence: 94%

Prevalence of Non-alcoholic Fatty Liver Disease and Steatohepatitis Risk Factors in Patients Undergoing Bariatric Surgery

et al. 2015

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“…40–65 (Appendix 2) The majority of the reports were from Japan (n=15), while 5 were from Europe, 3 from the U.S., and 3 from Brazil. Most included data on prevalence of two primary features of the metabolic syndrome, diabetes and obesity, with overall estimated sample-size weighted prevalence of 58% and 63% for diabetes and obesity, respectively.…”

Section: Resultsmentioning

confidence: 99%

Association Between Nonalcoholic Fatty Liver Disease and Risk for Hepatocellular Cancer, Based on Systematic Review

White

Kanwal

El–Serag

2012

Clinical Gastroenterology and Hepatology

678

508

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Background Non-alcoholic fatty liver disease (NAFLD) has been implicated as a possible cause of hepatocellular carcinoma (HCC) in several general review articles. We performed the first systematic review of the epidemiologic literature. Methods We searched PubMed for original reports published between 1/1992–12/2011 evaluating the association between NAFLD, non-alcoholic steatohepatitis (NASH) and cryptogenic cirrhosis (CC) presumptively NASH-related and the risk of HCC. Studies were categorized as offering potential direct evidence (e.g., cohort studies) or indirect evidence (e.g., case-control or cross-sectional studies or case-series) of an association. Results A total of 17 cohort studies [3 population-based, 9 clinic-based (6 limited to cirrhotics), and 5 natural history], 18 case-control and cross-sectional studies, and 26 case-series were study-eligible. NAFLD or NASH cohorts with few or no cirrhosis cases demonstrated a minimal HCC risk (cumulative HCC mortality between 0%–3% for study periods up to two decades). Consistently increased risk was observed in NASH-cirrhosis cohorts (cumulative incidence between 2.4% over 7-years to 12.8% over 3-years). However, HCC risk was substantially lower in NASH-cirrhosis (NASH-C) cohorts than in HCV-related cirrhosis cohorts. The determinants of elevated risk among NASH-C cohorts were unclear as most studies were underpowered to perform multivariate analysis. Conclusions This systematic review shows that despite several limitations, the epidemiologic evidence supports an association between NAFLD or NASH and an increased HCC risk that seems to be predominantly limited to individuals with cirrhosis.

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“…Also worthy of note is a recent study that demonstrated an increase in the prevalence of obesity in Brazil in the last few years, which may contribute to an increased incidence of NAFLD and its consequences. Supporting this assertion is a Brazilian study that evaluated the epidemiology and clinical characteristics of NAFLD in 1280 patients and observed obesity in 44.7% and overweight in 44.4% of cases . Taking these factors into account, the role of liver disease as a leading cause of death in Brazil is understandable.…”

Section: Discussionmentioning

confidence: 97%