Suboptimal treatment of dyslipidemia in patients with nonalcoholic fatty liver disease

Khoo, Su Pei; Wong, Vincent Wai‐Sun; Goh, George Boon-Bee; Fan, Jian‐Gao; Chan, Wah Kheong; Seto, Wai‐Kay; Chow, Wan Cheng

doi:10.1111/jgh.14794

Cited by 24 publications

(34 citation statements)

References 29 publications

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“…328 Strict control of low density lipoprotein cholesterol (LDL-C) is emphasized because many NAFLD patients treated with statins still did not meet their LDL-C treatment targets, which can itself increase the incidence of CVD. 329 A common adverse effect of statins is the asymptomatic elevation of aminotransferases, which usually appears within one year of starting statins and recovers spontaneously. 330 This increase in liver enzyme levels depends on the statin dose.…”

Section: -2-2 What Is the Effect Of Moderate Or Less Alcohol Consumption?mentioning

confidence: 99%

“…In a study using data from the National Health Information database of South Korea, statin treatment decreased not only the risk of NAFLD occurrence but also the development of fibrosis attributed to NALFD, regardless of diabetes mellitus [ 326 ]. Strict control of low density lipoprotein cholesterol (LDL-C) is emphasized because many NAFLD patients treated with statins still did not meet their LDL-C treatment targets, which can itself increase the incidence of CVD [ 327 ]. A common adverse effect of statins is the asymptomatic elevation of aminotransferases, which usually appears within 1 year of starting statins and recovers spontaneously [ 328 ].…”

Section: Treatmentmentioning

confidence: 99%

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KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease

Kang

Lee

Yoo³

et al. 2021

Clin Mol Hepatol

179

206

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Section: -2-2 What Is the Effect Of Moderate Or Less Alcohol Consumption?mentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease

Kang

Lee

Yoo³

et al. 2021

Clin Mol Hepatol

179

206

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“…Although the association between lifestyle habits and NAFLD has been well studied, clinicians and policymakers need to identify areas of deficiency so as to prevent and manage NAFLD. The controlled attenuation parameter (CAP)‐Asia study is a prospective multi‐centre study of real‐world patients with NAFLD in Asian centres and is a good platform to compare the clinical characteristics and management of NAFLD patients in different Asian countries and regions 17 . In the current study, we aimed to compare lifestyle habits of NAFLD patients in different Asian regions and explore the association between lifestyle habits and the severity of NAFLD.…”

Section: Introductionmentioning

confidence: 99%

Unhealthy lifestyle habits and physical inactivity among Asian patients with non‐alcoholic fatty liver disease

Zhang

Goh

Chan

et al. 2020

Liver International

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Background & Aims: Lifestyle modification is the cornerstone for the management of non-alcoholic fatty liver disease (NAFLD). We aim to understand lifestyle habits of NAFLD patients, compare across Asian regions and identify area of deficiency. Methods: In the multi-centre controlled attenuation parameter (CAP)-Asia study, we collected clinical data and lifestyle habit data of NAFLD patients from Singapore, mainland China, Hong Kong, Taiwan and Malaysia. Physical activity was assessed using the International Physical Activity Questionnaire. Results: A total of 555 patients were included in the final analysis (mean age 54.5 ± 11.2 years, 54.1% men and median liver stiffness 6.7 kPa). More patients from mainland China (27.4%) and Taipei (25.0%) were smokers. Modest drinking was more common in Taiwan (25.0%) and Hong Kong (18.2%); only 1.3% had binge drinking. Majority of patients drank coffee (64.0%) and tea (80.2%), with varying amounts and durations in different regions. Soft drinks consumption was most common in Singapore (62.2%) and Malaysia (57.7%). Only 29.7% of patients met the Physical Activity Guidelines Recommendations, with no major differences across regions. Patients with liver stiffness <10 kPa were more likely to report any vigorous activity, and sitting time was an independent factor associated with high CAP. Tea and coffee consumption were independently associated with high CAP and liver stiffness, respectively. Conclusions: Despite some heterogeneity, unhealthy lifestyle and physical inactivity are common across Asian regions. Patients with liver stiffness <10 kPa were more likely to report any vigorous activity. Healthcare providers may use the comparative data to identify areas of deficiency.

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“…Alcohol consumption should be limited to 2-3 drinks per week in women and 4-5 drinks per week in men and avoided in patients with advanced fibrosis (67,68), although high-quality data on the exact risk of progressive liver disease in patients with advanced fibrosis are still needed. Many PCPs and nonhepatologists discontinue statins when liver enzymes are elevated (9,69,70). However, numerous studies have also demonstrated that statins are safe and efficacious in patients with NAFLD and NASH, and they can be used to treat dyslipidemia in these patients, including those with compensated cirrhosis.…”

Section: Managementmentioning

confidence: 99%

Preparing for the NASH Epidemic: A Call to Action

et al. 2021

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Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are common conditions with a rising burden. Yet there are significant management gaps between clinical guidelines and practice in patients with NAFLD and NASH. Further, there is no single global guiding strategy for the management of NAFLD and NASH. The American Gastroenterological Association, in collaboration with 7 professional associations, convened an international conference comprising 32 experts in gastroenterology, hepatology, endocrinology, and primary care providers from the United States, Europe, Asia, and Australia. Conference content was informed by the results of a national NASH Needs Assessment Survey. The participants reviewed and discussed published literature on global burden, screening, risk stratification, diagnosis, and management of individuals with NAFLD, including those with NASH. Participants identified promising approaches for clinical practice and prepared a comprehensive, unified strategy for primary care providers and relevant specialists encompassing the full spectrum of NAFLD/NASH care. They also identified specific high-yield targets for clinical research and called for a unified, international public health response to NAFLD and NASH.Nonalcoholic fatty liver disease (NAFLD)-hepatic steatosis on imaging or histology in the absence of known causes-is rapidly becoming the most common cause of chronic liver disease worldwide (1). NAFL is histologically defined as the presence of $5% hepatic steatosis without evidence of hepatocellular injury, and nonalcoholic steatohepatitis (NASH) is defined as the presence of $5% hepatic steatosis and inflammation with hepatocyte injury (e.g., ballooning), with or without fibrosis (2). At least 20%-30% of patients with NAFLD develop NASH, which can lead to cirrhosis and associated complications, including hepatocellular cancer (HCC) (2). NASH is also associated with an increased risk of cardiovascular disease (3) and increased cardiovascular and liver-related mortality (4-6).Although most patients with NAFLD and NASH have traditionally been diagnosed and managed by hepatologists, the recent availability of noninvasive diagnostic procedures is expanding the role of other health care professionals likely to see patients with these conditions, particularly gastroenterologists, endocrinologists, obesity medicine specialists, and primary care providers (PCPs). Previous research has suggested that effectively treating NASH will require more education about both NAFLD and NASH among specialists and PCPs (7). Some published data also showed significant management gaps between published guidance and clinical practice in patients with NAFLD and NASH (8,9). Much of this disparity could come from a lack of recognition of the importance of NAFLD/NASH and an absence of a unified strategy that encompasses all disciplines involved in managing these patients across the full disease spectrum.To address this need, the American Gastroenterological Association (AGA) conducted a needs asses...

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Suboptimal treatment of dyslipidemia in patients with nonalcoholic fatty liver disease

Cited by 24 publications

References 29 publications

KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease

KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease

Unhealthy lifestyle habits and physical inactivity among Asian patients with non‐alcoholic fatty liver disease

Preparing for the NASH Epidemic: A Call to Action

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