Tests for diagnosing and monitoring non-alcoholic fatty liver disease in adults

Byrne, Christopher D.; Patel, Janisha; Scorletti, Eleonora; Targher, Giovanni

doi:10.1136/bmj.k2734

Cited by 95 publications

(139 citation statements)

References 34 publications

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“…However, we believe that more detailed analyses of the causes of heterogeneity will require collaborative pooling of individual participant data from large prospective studies, when these will become available in the future. Finally, another potential limitation of this meta‐analysis is that most studies used liver ultrasonography, which is the recommended first‐line imaging method for diagnosing NAFLD in clinical practice, whereas only one study used biopsy, which is the reference method for diagnosing and staging NAFLD …”

Section: Discussionmentioning

confidence: 99%

Systematic review with meta‐analysis: non‐alcoholic fatty liver disease is associated with a history of osteoporotic fractures but not with low bone mineral density

Mantovani

Dauriz

Gatti

et al. 2019

Aliment Pharmacol Ther

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Summary Background Several studies have explored the effect of non‐alcoholic fatty liver disease (NAFLD) on bone mineral density (BMD) and risk of osteoporotic fractures in adults. However, the extent to which NAFLD adversely affects bone health remains uncertain. Aim To provide a quantitative estimation of the magnitude of the association of NAFLD with BMD or history of osteoporotic fractures in adults. Methods We searched PubMed, Web of Science, and Scopus using predefined keywords to identify all observational studies, published up to 31 August 2018, in which NAFLD was diagnosed by imaging or histology; BMD was measured by dual energy X‐ray absorptiometry; and a self‐reported history of osteoporotic fractures was collected with interviewer‐assisted questionnaires. Data from selected studies were extracted, and meta‐analysis was performed using random‐effects modelling. Results Twelve cross‐sectional or case‐control studies with aggregate data on 30 041 adults of predominantly Asian ethnicity (30% with NAFLD) were included in the final analysis. No significant differences in BMD at different skeletal sites (whole body, lumbar spine, or femur) were observed between individuals with and without NAFLD. Conversely, NAFLD was associated with increased odds of osteoporotic fractures, especially in older Chinese men (n = 2 studies; random‐effects odds ratio 2.10, 95% CI 1.36‐3.25; I2 = 0%). Sensitivity analyses did not alter these findings. The funnel plot and Egger test did not reveal significant publication bias. Conclusions This meta‐analysis suggests that imaging‐defined or biopsy‐proven NAFLD is associated with a self‐reported history of osteoporotic fractures (principally in Chinese men), but not with low BMD, in middle‐aged and elderly individuals.

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Section: Discussionmentioning

confidence: 99%

Systematic review with meta‐analysis: non‐alcoholic fatty liver disease is associated with a history of osteoporotic fractures but not with low bone mineral density

Mantovani

Dauriz

Gatti

et al. 2019

Aliment Pharmacol Ther

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“…Although many investigative approaches exist, ultrasound is a simple and inexpensive first-line imaging technique to diagnose hepatic steatosis, and together with simple biochemical and immunological tests can rule out alternative pathologies. More specialist investigations, such as the ELF test and TE scans, are becoming available in primary care to diagnose liver fibrosis, and the use of these tests helps non-specialists identify those patients with NAFLD at higher risk of liver morbidity and mortality who require specialist referral and input 76. In patients with NAFLD, there is increased morbidity and mortality from T2DM and cardiovascular disease; therefore, it is important that NAFLD is considered as a common chronic liver disease with frequently occurring extrahepatic complications.…”

Section: Resultsmentioning

confidence: 99%

Diagnosis and management of non-alcoholic fatty liver disease

Jennison

Patel

Scorletti

et al. 2019

Postgraduate Medical Journal

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Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Western industrialised countries. The prevalence of NAFLD is increasing in parallel with the global rise in obesity and type 2 diabetes mellitus. NAFLD represents a spectrum of liver disease severity. NAFLD begins with accumulation of triacylglycerols in the liver (steatosis), and is defined by hepatic fatty infiltration amounting to greater than 5% by liver weight or the presence of over 5% of hepatocytes loaded with large fat vacuoles. In almost a quarter of affected individuals, steatosis progresses with the development of liver inflammation to non-alcoholic steatohepatitis (NASH). NASH is a potentially progressive liver condition and with ongoing liver injury and cell death can result in fibrosis. Progressive liver fibrosis may lead to the development of cirrhosis in a small proportion of patients. With the growing prevalence of NAFLD, there is an increasing need for a robust, accurate and non-invasive approach to diagnosing the different stages of this condition. This review will focus on (1) the biochemical tests and imaging techniques used to diagnose the different stages of NAFLD; and (2) a selection of the current management approaches focusing on lifestyle interventions and pharmacological therapies for NAFLD.

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“…[50] Noninvasive methods, such as imaging tools and serum biomarkers, have evolved greatly. [50] Noninvasive methods, such as imaging tools and serum biomarkers, have evolved greatly.…”

Section: Diagnosismentioning

confidence: 99%

“…[58,74] The NAS score consists of single scores for steatosis, inflammation and hepatocyte ballooning to quantify disease activity, and it has been proven to be inaccurate diagnosing of NASH due to the various criteria used by different groups. [50,61] Recent decades have witnessed great progress in the noninvasive evaluation methods for NAFLD, including imaging and serum biomarkers, which can serve as screening tools for the general population. SAF score includes ranks steatosis (S: 0-3), activity of ballooning and inflammation (A: 0-4) and fibrosis (F: 0-4).…”

Section: Invasive Biopsy and Histological Scorementioning

confidence: 99%

Insights into the Epidemiology, Pathogenesis, and Therapeutics of Nonalcoholic Fatty Liver Diseases

et al. 2018

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Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease which affects ≈25% of the adult population worldwide, placing a tremendous burden on human health. The disease spectrum ranges from simple steatosis to steatohepatitis, fibrosis, and ultimately, cirrhosis and carcinoma, which are becoming leading reasons for liver transplantation. NAFLD is a complex multifactorial disease involving myriad genetic, metabolic, and environmental factors; it is closely associated with insulin resistance, metabolic syndrome, obesity, diabetes, and many other diseases. Over the past few decades, countless studies focusing on the investigation of noninvasive diagnosis, pathogenesis, and therapeutics have revealed different aspects of the mechanism and progression of NAFLD. However, effective pharmaceuticals are still in development. Here, the current epidemiology, diagnosis, animal models, pathogenesis, and treatment strategies for NAFLD are comprehensively reviewed, emphasizing the outstanding breakthroughs in the above fields and promising medications in and beyond phase II.

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Tests for diagnosing and monitoring non-alcoholic fatty liver disease in adults

Cited by 95 publications

References 34 publications

Systematic review with meta‐analysis: non‐alcoholic fatty liver disease is associated with a history of osteoporotic fractures but not with low bone mineral density

Systematic review with meta‐analysis: non‐alcoholic fatty liver disease is associated with a history of osteoporotic fractures but not with low bone mineral density

Diagnosis and management of non-alcoholic fatty liver disease

Insights into the Epidemiology, Pathogenesis, and Therapeutics of Nonalcoholic Fatty Liver Diseases

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