scholarly journals Outcomes of NAFLD and MAFLD: Results from a community-based, prospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245762 ◽  
Author(s):  
Madunil Anuk Niriella ◽  
Dileepa Senajith Ediriweera ◽  
Anuradhani Kasturiratne ◽  
Shamila Thivanshi De Silva ◽  
Anuradha Supun Dassanayaka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Adverse Outcomes ◽  
Metabolic Dysfunction ◽  
Community Based ◽  
Alcoholic Fatty Liver ◽  
Metabolic Traits ◽  
New Onset

Background The term “metabolic (dysfunction)-associated fatty liver disease” (MAFLD) is suggested alternative for “non-alcoholic fatty liver disease” (NAFLD), as it better reflects metabolic dysfunction. No study has compared outcomes of the two diagnostic criteria. Methods In an ongoing, community-based, cohort-study in suburban Sri Lanka, participants were randomly selected in 2007. They were reassessed in 2014 to evaluate new-onset metabolic traits (MTs) and cardiovascular-events (CVEs). Baseline characteristics, MTs and CVEs after 7-years were compared in NAFLD and MAFLD and vs. controls. Similarly, we compared these parameters in those excluded by the NAFLD definition but captured by the MAFLD definition and vice versa, and vs. controls. Findings Of 2985 recruited in 2007, 940 (31.5%) had NAFLD, 990 (33.1%) had MAFLD and 362 (12.1%) were controls. When compared to NAFLD, MAFLD captured an additional 2.9% and lost 1.3% individuals. At baseline, anthropometric and metabolic traits were similar in NAFLD and MAFLD. At follow-up in 7-years, the risk of having new-onset MTs and fatal/non-fatal CVEs were similar in the groups, but were significantly higher compared to controls. Those excluded by the NAFLD definition but captured by the MAFLD definition showed higher baseline MTs compared to those excluded by the MAFLD definition but captured by the NAFLD definition, and had substantially higher risk for having new-onset MTs and CVEs compared to controls. Interpretation Although NAFLD and MAFLD had similar MTs at baseline, and similar outcomes after 7-years, those who were excluded by the NAFLD definition but captured by the MAFLD definition seem at higher risk of adverse outcomes than those excluded by the MAFLD definition but captured by the NAFLD definition. Although the increase in the index population was small, redefining NAFLD as MAFLD seemed to improve clinical utility.

scholarly journals Outcomes of NAFLD and MAFLD: Results from a community-based, prospective cohort study

2020 ◽  
Author(s):  
Madunil Anuk Niriella ◽  
Dileepa Senajith Ediriweera ◽  
Anuradhani Kasturiratne ◽  
Shamila Thivanshi De Silva ◽  
Anuradha Supun Dassanayake ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Structured Interview ◽  
Community Based ◽  
Serological Tests ◽  
Alcoholic Fatty Liver ◽  
Metabolic Traits ◽  
New Onset

Introduction Metabolic (dysfunction)-associated fatty liver disease (MAFLD) is a recently suggested alternative to Non-alcoholic fatty liver disease (NAFLD). We compared baseline metabolic traits and outcomes of NAFLD and MAFLD. Methods In an ongoing, community-based, cohort study, participants were first screened in 2007 by structured-interview, anthropometry, liver ultrasonography, and biochemical/serological tests and reassessed after 7-years. Baseline characteristics and outcomes after 7-years were compared in NAFLD and MAFLD, in those excluded by the NAFLD definition but captured by the MAFLD definition and those excluded by the MAFLD definition but captured by the NAFLD definition, versus controls. Results Of 2985 recruited in 2007, 940 (31.5%) had NAFLD, 990 (33.1%) had MAFLD and 362 (12.1%) were controls. Compared to NAFLD, MAFLD captured an additional 2.9% of individuals from the cohort and lost 1.3%. At baseline, anthropometric and metabolic traits were similar in NAFLD and MAFLD. At follow-up after 7 years, the odds of having new-onset metabolic traits and fatal/non-fatal CVEs were similar in the two groups, but were significantly higher in both the groups compared to controls. However, those excluded by the NAFLD definition but captured by the MAFLD definition, showed higher baseline metabolic derangements compared to those excluded by the MAFLD definition but captured by the NAFLD definition and had higher odds for having new onset metabolic traits and CVEs compared to controls. Conclusion Even though it was able to increase the index population by only a small proportion, redefining NAFLD as MAFLD seemed to improve clinical utility.

scholarly journals Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)—A Condition Associated with Heightened Sympathetic Activation

2021 ◽  
Vol 22 (8) ◽  
pp. 4241
Author(s):  
Revathy Carnagarin ◽  
Kearney Tan ◽  
Leon Adams ◽  
Vance B. Matthews ◽  
Marcio G. Kiuchi ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Metabolic Diseases ◽  
Treatment Strategies ◽  
Adverse Outcomes ◽  
Metabolic Dysfunction ◽  
Sympathetic Activation ◽  
Beneficial Effects ◽  
Adverse Health Outcomes

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common liver disease affecting a quarter of the global population and is often associated with adverse health outcomes. The increasing prevalence of MAFLD occurs in parallel to that of metabolic syndrome (MetS), which in fact plays a major role in driving the perturbations of cardiometabolic homeostasis. However, the mechanisms underpinning the pathogenesis of MAFLD are incompletely understood. Compelling evidence from animal and human studies suggest that heightened activation of the sympathetic nervous system is a key contributor to the development of MAFLD. Indeed, common treatment strategies for metabolic diseases such as diet and exercise to induce weight loss have been shown to exert their beneficial effects at least in part through the associated sympathetic inhibition. Furthermore, pharmacological and device-based approaches to reduce sympathetic activation have been demonstrated to improve the metabolic alterations frequently present in patients with obesity, MetSand diabetes. Currently available evidence, while still limited, suggests that sympathetic activation is of specific relevance in the pathogenesis of MAFLD and consequentially may offer an attractive therapeutic target to attenuate the adverse outcomes associated with MAFLD.

scholarly journals Role of Insulin Resistance in MAFLD

2021 ◽  
Vol 22 (8) ◽  
pp. 4156
Author(s):  
Yoshitaka Sakurai ◽  
Naoto Kubota ◽  
Toshimasa Yamauchi ◽  
Takashi Kadowaki
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
De Novo Lipogenesis ◽  
Hepatic Insulin Resistance ◽  
Metabolic Dysfunction ◽  
Alcoholic Fatty Liver ◽  
Fat Accumulation

Many studies have reported that metabolic dysfunction is closely involved in the complex mechanism underlying the development of non-alcoholic fatty liver disease (NAFLD), which has prompted a movement to consider renaming NAFLD as metabolic dysfunction-associated fatty liver disease (MAFLD). Metabolic dysfunction in this context encompasses obesity, type 2 diabetes mellitus, hypertension, dyslipidemia, and metabolic syndrome, with insulin resistance as the common underlying pathophysiology. Imbalance between energy intake and expenditure results in insulin resistance in various tissues and alteration of the gut microbiota, resulting in fat accumulation in the liver. The role of genetics has also been revealed in hepatic fat accumulation and fibrosis. In the process of fat accumulation in the liver, intracellular damage as well as hepatic insulin resistance further potentiates inflammation, fibrosis, and carcinogenesis. Increased lipogenic substrate supply from other tissues, hepatic zonation of Irs1, and other factors, including ER stress, play crucial roles in increased hepatic de novo lipogenesis in MAFLD with hepatic insulin resistance. Herein, we provide an overview of the factors contributing to and the role of systemic and local insulin resistance in the development and progression of MAFLD.

scholarly journals De novo Portal Vein Thrombosis in Non-Cirrhotic Non-Alcoholic Fatty Liver Disease: A 9-Year Prospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Ahmed Abdel-Razik ◽  
Nasser Mousa ◽  
Walaa Shabana ◽  
Ahmed H. Yassen ◽  
Mostafa Abdelsalam ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Portal Vein ◽  
Fatty Liver ◽  
Portal Vein Thrombosis ◽  
Prospective Cohort ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Vein Thrombosis ◽  
Alcoholic Fatty Liver Disease

Background and Aims: Approximately 30–40% of portal vein thrombosis (PVT) remains of unknown origin. The association between non-alcoholic fatty liver disease (NAFLD) and PVT is a matter of debate. This study aimed to investigate the association between PVT and NAFLD.Methods: We included 94 out of 105 consecutive NAFLD patients in this prospective cohort study in addition to 94 from the healthy control group. We evaluated biochemical, clinical, immunological, and histopathological parameters; waist circumference (WC); leptin; adiponectin; and leptin/adiponectin ratio (LAR) for all participants at baseline and every 3 years thereafter. We described the characteristics of participants at baseline and showed individual WC, LAR, and PVT characteristics. Potential parameters to predict PVT development within 9 years were determined.Results: PVT developed in eight (8.5%) patients, mainly in the portal trunk. Univariate analysis showed three PVT-associated factors: diabetes mellitus (P = 0.013), WC (P < 0.001), and LAR (P = 0.002). After adjusting multiple confounding variables, the multivariate model showed that the only significant variables were WC and LAR. By applying the receiver operating characteristic curve, WC had 98.8% specificity, 87.5% sensitivity, and 0.894 area under the curve (AUC) for prediction of PVT (P < 0.001) at cutoff values of > 105 cm. In comparison, LAR had 60.5% specificity, 87.5% sensitivity, and 0.805 AUC for PVT prediction (P < 0.001) at cutoff values of >7.5.Conclusions: This study suggests that increased central obesity and LAR were independently associated with PVT development in non-cirrhotic NAFLD patients, and they should be considered risk factors that may participate in PVT multifactorial pathogenesis.

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