Prevalence of Risk Factors for Nonalcoholic Fatty Liver Disease in Middle-Aged and Elderly Patients With Cryptogenic Cirrhosis

Kumar, C Bharath; Goel, Ashish; Jaleel, Rajeeb; David, Deepu; Zachariah, Uday; Ramachandran, Jeyamani; Eapen, C E

doi:10.1016/j.jceh.2021.05.008

Cited by 3 publications

(2 citation statements)

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“…The obesity and metabolic syndrome epidemics in the last two decades have been dramatically associated with increasing occurrences of NAFLD. Interestingly, previous studies have shown that overweight and metabolic disorders are more likely to be found among cryptogenic chronic hepatitis subjects than in other causes of liver disease (8,9,23). Clark et al have also demonstrated that patients with unexplained aminotransferase elevation present with significantly higher body mass index, waist circumference, triglycerides, and fasting insulin, and lower HDLfeatures associated with NAFLD (24).…”

Section: Discussionmentioning

confidence: 99%

“…It is also important to mention that cryptogenic hepatitis may reflect a late phase of disease in which classical findings have been lost or obscured transiently (1). On the other hand, the new definition of metabolic-associated fatty liver disease has recently increased the potential for the etiological diagnosis of several patients previously labeled with cryptogenic hepatitis, especially among cirrhotics (7)(8)(9)(10). Lysosomal acid lipase deficiency (LAL-D), silent autoimmune hepatitis, occult viral hepatitis, alcohol-related liver injury, and alpha-1 antitrypsin deficiency have also been linked to the cryptogenic liver disease spectrum and can histologically mimic non-alcoholic fatty liver disease.…”

Section: Introductionmentioning

confidence: 99%

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Cryptogenic chronic hepatitis: looking for an ideal diagnostic algorithm

Cançado,

Candolo,

Nardelli

et al. 2023

Front. Gastroenterol.

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IntroductionCryptogenic chronic hepatitis is a growing cause of liver transplants, affecting 5%–15% of patients with chronic liver diseases. This study aimed to identify underlying causes of cryptogenic liver disease in a Brazilian cohort and propose a new diagnostic algorithm, including investigation for metabolic-dysfunction-associated fatty liver disease (MAFLD) and lysosomal acid lipase deficiency (LAL-D).MethodsA retrospective analysis was conducted on 326 patients with presumed cryptogenic hepatitis.ResultsUsing Czaja’s algorithm, non-alcoholic fatty liver disease was diagnosed in 21.3% of patients, while alpha-1 antitrypsin deficiency, alcoholic liver disease, autoimmune hepatitis, hemochromatosis, biliary-related hepatitis, viral hepatitis, Budd–Chiari syndrome, glycogenosis, drug-induced liver injury, and Wilson’s disease were diagnosed in smaller proportions (< 3.5% each). LAL-D was found in 1% of patients, and 53.6% of patients remained with cryptogenic hepatitis. The etiology of the liver disease in a subset of patients undergoing liver transplantation was updated post hoc based on explant histology, and non-alcoholic steatohepatitis was found in 52.5% of patients. By incorporating the concept of MAFLD, the new algorithm could diagnose 49.1% of patients, reducing the number of individuals without an etiological diagnosis by 11.4%.ConclusionOne-third of patients with initially presumed cryptogenic liver disease were diagnosed with MAFLD. LAL-D should be considered in patients with chronic liver disease of unknown etiology. The updated diagnostic algorithm proposed in this study could improve diagnostic accuracy and aid in the management of patients with cryptogenic hepatitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cryptogenic chronic hepatitis: looking for an ideal diagnostic algorithm

Cançado,

Candolo,

Nardelli

et al. 2023

Front. Gastroenterol.

View full text Add to dashboard Cite

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Global epidemiology of type 2 diabetes in patients with NAFLD or MAFLD: a systematic review and meta-analysis

Cao,

An,

Liu

et al. 2024

BMC Med

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Background Non-alcoholic fatty liver disease (NAFLD) and metabolic-associated fatty liver disease (MAFLD) shares common pathophysiological mechanisms with type 2 diabetes, making them significant risk factors for type 2 diabetes. The present study aimed to assess the epidemiological feature of type 2 diabetes in patients with NAFLD or MAFLD at global levels. Methods Published studies were searched for terms that included type 2 diabetes, and NAFLD or MAFLD using PubMed, EMBASE, MEDLINE, and Web of Science databases from their inception to December 2022. The pooled global and regional prevalence and incidence density of type 2 diabetes in patients with NAFLD or MAFLD were evaluated using random-effects meta-analysis. Potential sources of heterogeneity were investigated using stratified meta-analysis and meta-regression. Results A total of 395 studies (6,878,568 participants with NAFLD; 1,172,637 participants with MAFLD) from 40 countries or areas were included in the meta-analysis. The pooled prevalence of type 2 diabetes among NAFLD or MAFLD patients was 28.3% (95% confidence interval 25.2–31.6%) and 26.2% (23.9–28.6%) globally. The incidence density of type 2 diabetes in NAFLD or MAFLD patients was 24.6 per 1000-person year (20.7 to 29.2) and 26.9 per 1000-person year (7.3 to 44.4), respectively. Conclusions The present study describes the global prevalence and incidence of type 2 diabetes in patients with NAFLD or MAFLD. The study findings serve as a valuable resource to assess the global clinical and economic impact of type 2 diabetes in patients with NAFLD or MAFLD.

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