The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology

Chalasani, Naga; Younossi, Zobair M.; Lavine, Joel E.; Diehl, Anna Mae; Brunt, Elizabeth M.; Cusi, Kenneth; Charlton, Michael; Sanyal, Arun J.

doi:10.1053/j.gastro.2012.04.001

Cited by 2,465 publications

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“…Non-alcoholic fatty liver disease (NAFLD) is a metabolic disorder characterized by histopathological or imaging evidence of diffuse fatty liver disease that occurs usually in presence of metabolic risk factors (e.g., hypercholesterolemia and/or diabetes) and without an identifiable etiology of liver disease [1]. NAFLD is common in Western countries, presents inter-racial differences, and its prevalence has been estimated around 25-30 % in the general population, while the incidence varies according to the populations studied (from 29/100,000 to 86/1000) [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…NAFLD is common in Western countries, presents inter-racial differences, and its prevalence has been estimated around 25-30 % in the general population, while the incidence varies according to the populations studied (from 29/100,000 to 86/1000) [2,3]. Two NAFLD groups can be distinguished, NAFLD, where there is no evidence of hepatocytes ballooning or fibrosis, and non-alcoholic steatohepatitis (NASH), in which inflammation with hepatocyte injury predominates, with or without fibrosis [1]. The distinction between these two conditions is essential, because NASH patients are at higher risk of liver failure, cirrhosis, and hepatocellular carcinoma [1].…”

Section: Introductionmentioning

confidence: 99%

“…Two NAFLD groups can be distinguished, NAFLD, where there is no evidence of hepatocytes ballooning or fibrosis, and non-alcoholic steatohepatitis (NASH), in which inflammation with hepatocyte injury predominates, with or without fibrosis [1]. The distinction between these two conditions is essential, because NASH patients are at higher risk of liver failure, cirrhosis, and hepatocellular carcinoma [1]. Liver biopsy is the gold standard technique to detect early liver fibrosis, but is an invasive procedure and not free of complications.…”

Section: Introductionmentioning

confidence: 99%

“…Liver biopsy is the gold standard technique to detect early liver fibrosis, but is an invasive procedure and not free of complications. In the last years, some clinical/laboratory scores have been created to assess the risk of NASH evolution and the need of biopsy in these patients [1]. Among all, NALFD fibrosis score seems to predict well the presence of significant fibrosis [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Hepatic artery resistive index (HARI) and non-alcoholic fatty liver disease (NAFLD) fibrosis score in NAFLD patients: cut-off suggestive of non-alcoholic steatohepatitis (NASH) evolution

Tana

Tana²,

Rossi

et al. 2016

J Ultrasound

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Purpose of the study Conventional ultrasound (US) is reliable to reveal the presence of non-alcoholic fatty liver disease (NAFLD), but it is neither sensitive nor specific to reveal fibrosis clues, except in advanced stages where signs of cirrhosis are evident. NALFD fibrosis score is a noninvasive parameter that predicts well the presence of significant fibrosis, but correlations with US parameters are lacking. The aim of this study was, therefore, to compare resistive index of hepatic artery (HARI) of NAFLD patients with different severity degrees of diffuse fatty liver disease vs HARI of controls, and to compare HARI of NAFLD patients with different NAFLD fibrosis scores vs HARI of controls. Methods This was a spontaneous, no-profit observational study conducted in our US department between December 2013 and July 2014. Patients with NAFLD with different severity of disease and healthy controls were included. Echogenicity and size of liver and spleen, maximum portal vein velocity, RI, peak systolic velocity (PSV), and end diastolic velocity (EDV) of splenic artery, PSV, EDV, and RI of hepatic artery, and NAFLD fibrosis score were acquired and compared between groups.Results HARI was significantly lower in NAFLD patients than controls (p \ 0.0001). A significant difference was also found between the groups of NAFLD severity (p \ 0.0001). There was also a difference between HARI of NAFLD patients with different NAFLD fibrosis scores vs HARI of controls (p \ 0.0001) with a positive correlation between HARI and NAFLD fibrosis score. Conclusion and discussion Conventional Doppler US can be helpful to detect NAFLD patients with the risk of fibrous tissue accumulation. HARI tends to exceed the range of controls for patients with NAFLD fibrosis score greater than 0.675. The detection of HARI greater than 0.9 in NAFLD patients, regardless of the US degree of severity of steatosis, might suggest the execution of biopsy to predict the risk of progression to steatohepatitis and fibrous tissue accumulation. Low values of HARI may be expression of lower risk, which does not necessitate any biopsy.Keywords Hepatic artery resistive index Á Non-alcoholic fatty liver disease Á NAFLD fibrosis score Á Non-alcoholic steatohepatitis Á Ultrasound Á Color Doppler Sommario Scopo dello studio L'ecografia convenzionale è risultata affidabile nel rilevare la presenza di steatosi epatica, tra cui la forma non alcolica (NAFLD), ma non è né sensibile né specifica nel rivelare indizi suggestivi di fibrosi, tranne che in fase avanzata dove sono presenti segni conclamati di cirrosi. Il NALFD fibrosis score è un parametro non invasivo che predice bene la presenza di fibrosi significativa, ma non ci sono dati in letteratura riguardanti una possibile correlazione con i parametri ecografici. Lo scopo di questo studio è stato quindi quello di confrontare HARI dei pazienti con NAFLD a differente grado di severità di steatosi epatica vs l'HARI dei controlli, e di confrontare HARI dei pazienti affetti da NAFLD a differente NAFLD fibrosis score...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hepatic artery resistive index (HARI) and non-alcoholic fatty liver disease (NAFLD) fibrosis score in NAFLD patients: cut-off suggestive of non-alcoholic steatohepatitis (NASH) evolution

Tana

Tana²,

Rossi

et al. 2016

J Ultrasound

View full text Add to dashboard Cite

show abstract

“…Interestingly, cardiovascular complications are the leading cause of morbidity and mortality in NAFLD subjects [5][6][7]. Moreover, the presence of MS leads to an increased risk of T2DM and cardiovascular disease (CVD), leading these subjects to be a high-risk group for increased morbidity and allcause mortality with a shortened lifespan compared with the general population.…”

Section: Introductionmentioning

confidence: 99%