scholarly journals Treatments for NAFLD: State of Art

2021 ◽  
Vol 22 (5) ◽  
pp. 2350
Author(s):  
Alessandro Mantovani ◽  
Andrea Dalbeni
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Current Knowledge ◽  
Lipid Lowering ◽  
Major Health Problem ◽  
Alcoholic Fatty Liver ◽  
History Of ◽  
Glucagon Like Peptide 1 ◽  
Lipid Lowering Agents

Non-alcoholic fatty liver disease (NAFLD) is to date the most common chronic liver disease in clinical practice and, consequently, a major health problem worldwide. It affects approximately 30% of adults in the general population and up to 70% of patients with type 2 diabetes (T2DM). Despite the current knowledge of the epidemiology, pathogenesis, and natural history of NAFLD, no specific pharmacological therapies are until now approved for this disease and, consequently, general strategies have been proposed to manage it. They include: (a) lifestyle change in order to promote weight loss by diet and physical activity, (b) control of the main cardiometabolic risk factors, (c) correction of all modifiable risk factors leading the development and progression of advanced forms of NAFLD, and (d) prevention of hepatic and extra-hepatic complications. In the last decade, several potential agents have been widely investigated for the treatment of NAFLD and its advanced forms—shedding some light but casting a few shadows. They include some glucose-lowering drugs (such as pioglitazone, glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose co-transporter-2 (SGLT-2) inhibitors), antioxidants (such as vitamin E), statins or other lipid lowering agents, bile and non-bile acid farnesoid X activated receptor (FXR) agonists, and others. This narrative review discusses in detail the different available approaches with the potential to prevent and treat NAFLD and its advanced forms.

Non-alcoholic fatty liver disease is associated with an increased prevalence of atrial fibrillation in hospitalized patients with Type 2 diabetes

2013 ◽  
Vol 125 (6) ◽  
pp. 301-310 ◽  
Author(s):  
Giovanni Targher ◽  
Alessandro Mantovani ◽  
Isabella Pichiri ◽  
Riccardo Rigolon ◽  
Marco Dauriz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Hospitalized Patients ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

NAFLD (non-alcoholic fatty liver disease) and AF (atrial fibrillation) are two pathological conditions that are highly prevalent in developed countries and share multiple risk factors. The relationship between NAFLD and AF in Type 2 diabetes is currently unknown. We studied a hospital-based sample of 702 patients with Type 2 diabetes discharged from our Division of Endocrinology during 2007–2011. The diagnosis of AF was confirmed in affected participants on the basis of ECGs and medical history by experienced cardiologists. NAFLD was defined by ultrasonographic detection of hepatic steatosis in the absence of other liver diseases. Of the 702 hospitalized patients included in the study, 514 (73.2%) of them had NAFLD and 85 (12.1%) had persistent or permanent AF. NAFLD was associated with an increased risk of prevalent AF {OR (odds ratio), 3.04 [95% CI (confidence interval), 1.54–6.02]; P<0.001}. Adjustments for age, sex, systolic BP (blood pressure), HbA1c, (glycated haemoglobin), estimated GFR (glomerular filtration rate), total cholesterol, electrocardiographic LVH (left ventricular hypertrophy), COPD (chronic obstructive pulmonary disease), and prior history of HF (heart failure), VHD (valvular heart disease) or hyperthyroidism did not attenuate the association between NAFLD and AF [adjusted OR, 5.88 (95% CI, 2.72–12.7); P<0.001]. In conclusion, our results show that ultrasound-diagnosed NAFLD is strongly associated with an increased prevalence of persistent or permanent AF in patients with Type 2 diabetes, independently of several clinical risk factors for AF. The potential impact of NAFLD on AF deserves particular attention, especially with respect to the implications for screening and surveillance strategies in the growing number of patients with NAFLD.

scholarly journals Frequency of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus and its associated risk factors

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Shaista Kanwal ◽  
Tahir Ghaffar ◽  
Azizul Hasan Aamir ◽  
Khalid Usman
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Associated Risk Factors ◽  
Alcoholic Fatty Liver Disease

Objective: Non-Alcoholic Fatty Liver Disease (NAFLD) is emerging as a major public health problem globally especially in patients with Type-2 Diabetes mellitus (T2DM). This study aimed to assess the frequency of NAFLD in patients with T2DM and to study its associated risk factors. Methods: This descriptive study was conducted from April 2020 to October 2020 at the Hayatabad Medical Complex, Peshawar. Adult patients with T2DM were included in the study and underwent abdominal ultrasound for the identification of NAFLD. All the relevant clinical and biochemical characteristics were measured. Results: Out of 384 participants, 236 patients (61.5%) had NAFLD on ultrasound. Patients with NAFLD had higher mean BMI, higher HbA1c, increased waist circumference, raised ALT, higher triglyceride, and low HDL. Logistic regression analysis revealed a statistically significant association with central obesity (OR = 5.448, 95% CI = 1.416-20.959, p = 0.014), higher BMI (OR = 4.435, 95% CI = 2.127-9.246, p < 0.0001), higher HbA1c [> 11%] (OR = 3.602, 95% CI = 1.438-9.019, p = 0.006), and elevated ALT (OR = 3.211, 95% CI = 1.509-6.835, p = 0.002). The highest odds for NAFLD were found for hypertriglyceridemia (OR = 11.624, 95% CI = 5.405-24.998, p < 0.0001) and low HDL (OR = 11.543, 95% CI = 2.590-51.439, p = 0.001), respectively. Conclusions: High frequency of NAFLD along with its associated clinical and laboratory risk factors were revealed. This underpins the significance of screening T2DM patients for NAFLD and assessment for and modification of its associated risk factors in routine clinical practice. doi: https://doi.org/10.12669/pjms.37.5.4211 How to cite this:Kanwal S, Ghaffar T, Aamir AH, Usman K. Frequency of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus and its associated risk factors. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4211 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The Association Between Risk Factors And Ultrasound-Based Grades Of Non-Alcoholic Fatty Liver Disease In Type-2 Diabetes Patients

2019 ◽  
Vol 5 (1) ◽  
pp. 47-59
Author(s):  
FX Himawan Haryanto Jong ◽  
Prettysun Ang Mellow
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Liver Disease ◽  
Total Cholesterol ◽  
Fatty Liver Disease ◽  
Density Lipoprotein ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) has become more common as the cause of cirrhosis and liver cancer. The liver disease is highly prevalent in people with type-2 diabetes. Indonesia is not spared from the global epidemic of type-2 diabetes. The ultrasound examination is clinically easy-to-use, economical and non-invasive as a tool to detect NAFLD, compared to the gold standard, liver biopsy. To date, there has been no study in Indonesia to link risk factors and ultrasound-based severity grading of NAFLD. Aim: To understand the association between risk factors and ultrasound-based grades of NAFLD in patients with type-2 diabetes. Method: The present study was an observational study with a cross-sectional design (May-October 2018) that involved 82 type-2 diabetes outpatients of the internal medicine clinic in the Gotong Royong Hospital (Surabaya, Indonesia). The risk factors assessed were gender, age, diabetes duration, obesity (anthropometric measurement: body mass index/ BMI, waist circumference and waist-to-hip ratio), glycemic control (hemoglobin A1c/ HbA1c level) and dyslipidemia (lipid profile: total cholesterol, low-density lipoprotein/ LDL, high-density lipoprotein/ HDL and triglyceride). The ultrasound-based grades of NAFLD consisted of grade 0 (no NAFLD), grade 1 (increased liver echogenicity with normal images of intrahepatic vessel lines and diaphragm), grade 2 (blurred image of intrahepatic vessel lines) and grade 3 (blurred images of intrahepatic vessel lines and diaphragm). Statistical p-value was significant at ≤ 0.05. Results: Seventy-eight subjects (95,1%) had NAFLD. The ultrasound-based NAFLD grades were significantly different across age groups (Kruskal-Wallis) but the Spearman’s rank correlation test result was not significant. Body mass index and total cholesterol were positively correlated (r = 0.390 and 0.237, respectively) with the NAFLD grades. Conclusion: Higher BMI and total cholesterol are associated with increased ultrasound-based NAFLD grades.

scholarly journals Evaluation of Sucrose‐enriched Diet Consumption in the Development of Risk Factors Associated to Type 2 Diabetes, Atherosclerosis and Non‐alcoholic Fatty Liver Disease in a Murine Model

2020 ◽  
Vol 34 (S1) ◽  
pp. 1-1
Author(s):  
Carolina Gabriela Plazas-Guerrero ◽  
Selene de Jesùs Acosta-Cota ◽  
Francisco Humberto Castro-Sánchez ◽  
Efrén Rafael Ríos-Burgueño ◽  
Juan Ignacio Sarmiento-Sánchez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Murine Model ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Factors Associated ◽  
Alcoholic Fatty Liver Disease

Evaluation of sucrose-enriched diet consumption in the development of risk factors associated to type 2 diabetes, atherosclerosis and non-alcoholic fatty liver disease in a murine model

2019 ◽  
pp. 1-19
Author(s):  
Carolina Gabriela Plazas Guerrero ◽  
Selene De Jesús Acosta Cota ◽  
Francisco Humberto Castro Sánchez ◽  
Marcela De Jesús Vergara Jiménez ◽  
Efrén Rafael Ríos Burgueño ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Murine Model ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Factors Associated ◽  
Alcoholic Fatty Liver Disease

scholarly journals Judicious Use of Lipid Lowering Agents in the Management of NAFLD

Diseases ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 87 ◽  
Author(s):  
Umair Iqbal ◽  
Brandon Perumpail ◽  
Nimy John ◽  
Sandy Sallam ◽  
Neha Shah ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Damage ◽  
Lipid Lowering ◽  
Western World ◽  
Prospective Data ◽  
Alcoholic Fatty Liver ◽  
Increased Risk ◽  
Lipid Lowering Agents ◽  
Alcoholic Fatty Liver Disease ◽  
Biochemical Abnormalities

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the Western world. NAFLD encompasses a spectrum of histological features, including steatosis, steatohepatitis with balloon degeneration, and hepatic fibrosis leading to cirrhosis. In patients with advanced liver damage, NAFLD is associated with an increased risk of hepatocellular carcinoma. Diabetes mellitus, hypertension, and dyslipidemia are components of metabolic syndrome and are commonly associated with NAFLD. Cardiovascular disease is the leading cause of mortality in patients with NAFLD. Therefore, it is important to pre-emptively identify and proactively treat conditions like hyperlipidemia in an effort to favorably modify the risk factors associated with cardiovascular events in patients with NAFLD. The management of hyperlipidemia has been shown to reduce cardiovascular mortality and improve histological damage/biochemical abnormalities associated with non-alcoholic steatohepatitis (NASH), a subset of NAFLD with advance liver damage. There are no formal guidelines available regarding the use of anti-hyperlipidemic drugs, as prospective data are lacking. The focus of this article is to discuss the utility of lipid-lowering drugs in patients with NAFLD.

scholarly journals A family history of type 2 diabetes as a predictor of fatty liver disease in diabetes-free individuals with excessive body weight

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giovanni De Pergola ◽  
Fabio Castellana ◽  
Roberta Zupo ◽  
Sara De Nucci ◽  
Francesco Panza ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Family History ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Excess Weight ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
History Of

AbstractComprehensive screening for non-alcoholic fatty liver disease (NAFLD) may help prompt clinical management of fatty liver disease. A family history, especially of diabetes, has been little studied as a predictor for NAFLD. We characterized the cross-sectional relationship between a family history of type 2 diabetes (FHT2D) and NAFLD probability in 1185 diabetes-free Apulian (Southern-Italy) subjects aged > 20 years with overweight or obesity not receiving any drug or supplementation. Clinical data and routine biochemistry were analysed. NAFLD probability was defined using the fatty liver index (FLI). A first-degree FHT2D was assessed by interviewing subjects and assigning a score of 0, 1, or 2 if none, only one, or both parents were affected by type 2 diabetes mellitus (T2DM). Our study population featured most females (70.9%, N = 840), and 48.4% (N = 574) of the sample had first-degree FHT2D. After dividing the sample by a FHT2D, we found a higher BMI, Waist Circumference (WC), and diastolic blood pressure shared by FHT2D subjects; they also showed altered key markers of glucose homeostasis, higher triglyceride levels, and worse liver function. FLI scores were significantly lower in subjects without a first-degree FHT2D. After running logistic regression models, a FHT2D was significantly associated with the NAFLD probability, even adjusting for major confounders and stratifying by age (under and over 40 years of age). A FHT2D led to an almost twofold higher probability of NAFLD, regardless of confounding factors (OR 2.17, 95% CI 1.63 to 2.89). A first-degree FHT2D acts as an independent determinant of NAFLD in excess weight phenotypes, regardless of the age group (younger or older than 40 years). A NAFLD risk assessment within multidimensional screening might be useful in excess weight subjects reporting FHT2D even in the absence of diabetes.

scholarly journals Glucagon-Like Peptide-1 Receptor Agonists for Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes: A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Chloe Wong ◽  
Ming Hui Lee ◽  
Clyve Yu Leon Yaow ◽  
Yip Han Chin ◽  
Xin Lei Goh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Alcoholic Fatty Liver Disease

ObjectiveNon-alcoholic fatty liver disease is highly prevalent in patients with type 2 diabetes mellitus. Studies on glucagon-like peptide-1 receptor agonists for the treatment of non-alcoholic fatty liver disease have reported promising results. Despite this, there has been limited evidence of its efficacy in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus. This meta-analysis examined existing evidence on the efficacy of glucagon-like peptide-1 receptor agonists on the management of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus.MethodsMedline, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for articles discussing the efficacy of glucagon-like peptide-1 receptor agonists on non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Values of standardized mean differences (SMD) and risk ratio (RR) were determined for continuous outcomes and dichotomous outcomes respectively.Results8 studies involving 1,454 patients from 5 randomized controlled trials and 3 cohort studies were included in the analysis. Our analysis found significant improvements in hepatic fat content, liver biochemistry, body composition, glucose parameters, lipid parameters, insulin sensitivity and inflammatory markers following glucagon-like peptide-1 receptor agonist treatment. Glucagon-like peptide-1 receptor agonists significantly decreased hepatic fat content compared to metformin and insulin-based therapies. Glucagon-like peptide-1 receptor agonists also improved fibrosis markers, but this did not reach statistical significance.ConclusionWith a high prevalence of obesity and non-alcoholic fatty liver disease among patients with type 2 diabetes mellitus, glucagon-like peptide-1 receptor agonist treatment shows promise in improving both diabetes and non-alcoholic fatty liver disease phenotype.

scholarly journals Assessment of liver involvement in type 2 diabetes mellitus using fibroscan® and correlation with risk factors

2019 ◽  
Vol 6 (3) ◽  
pp. 594
Author(s):  
Alagesan . ◽  
Sairam Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Stiffness ◽  
Diabetic Patients ◽  
Alcoholic Fatty Liver

Background: Non‐alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver injury. The most important predictor of mortality in NAFLD is the extent of liver fibrosis. Advanced liver fibrosis is associated with overall and liver related mortality. The upcoming non-invasive imaging modality for the evaluation of liver fibrosis is transient elastography (TE) (Fibro scan®). The aim of this study is to assess hepatopathy among diabetics using TE and to correlate the degree of hepatopathy with the associated risk factors.Methods: Type 2 diabetes mellitus patients were assessed for liver stiffness using TE. Liver stiffness was correlated with the associated risk factors. Authors recruited 100 patients from diabetic clinic in tertiary care teaching hospital.Results: About 55% of males and 39% of females had increased liver stiffness. 14% of males and 11% of females had severe fibrosis(F3-F4). Body mass index, waist circumference, fasting blood sugar levels, and liver enzymes, had significant positive correlation with liver stiffness whereas triglyceride levels, high-density lipoprotein levels, and duration of diabetes mellitus did not correlate with liver stiffness.Conclusions: Diabetic patients have high prevalence of NAFLD and advanced fibrosis. Those with obesity and dyslipidaemia are at particularly high risk. Type 2 diabetes mellitus patients with hepatopathy can be easily identified using TE scan eliminating the need for liver biopsy. The establishment of a national program for the recognition of NAFLD is essential to reduce the risk of liver disease progression.

scholarly journals Frequency of non-alcoholic fatty liver disease (NAFLD) and its associated risk factors among Type-2 diabetics

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Alia Ali ◽  
Muhammad Joher Amin ◽  
Muhammad Uthman Ahmed ◽  
Azeem Taj ◽  
Muhammad Aasim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Type 2 Diabetic Patients ◽  
Alcoholic Fatty Liver ◽  
Type 2 Diabetics ◽  
Associated Risk Factors ◽  
Alcoholic Fatty Liver Disease

Objectives: To determine the frequency of Non-Alcoholic Fatty Liver Disease (NAFLD) and its associated risk factors among Type-2 Diabetic patients. Methods: This cross-sectional study was conducted in Diabetic Clinic of Shaikh Zayed Postgraduate Medical Institute Lahore from September 2019-February 2020. Type-2 diabetics regardless of age were divided into two groups, one with fatty liver disease and the other without this, evaluated by Abdominal Ultrasonography and were further evaluated by measurement of BMI, obesity, HbA1c and lipid profile. Exclusion criteria were patients having history of or currently taking alcohol, chronic Liver Disease of any cause and intake of hepatotoxic drugs. Qualitative measures were compared between groups by using Chi-square test. Binary logistic regression was used to see the association of factors with fatty liver disease. P-value ≤ 0.05 was considered significant. Results: A total of 185 subjects were included in the study with the mean age of 53.0±9.0 years. About 54.6% patients were diagnosed to have fatty liver disease. When compared the cases with and without fatty liver disease, age and HDL cholesterol had no significant difference between groups while other measures like BMI, TGs & cholesterol levels, ALT and AST were significantly higher among cases with NAFLD. BMI >24.5, HbA1c >7.0 and ALT >40.0 can predict NAFLD among Type-2 diabetic patients with 96.8% accuracy. Conclusion: There is high prevalence of NAFLD among Type-2 diabetic patients and strong association between Type-2 diabetics with NAFLD and risk factors like; obesity, high HbA1c, hyperlipidemia and high ALT. Therefore, early recognition by ultrasonography in high risk patients and intervention like life style modification, maintenance of healthy weight, obesity prevention, treatment of dyslipidemia and good glycemic control should be achieved in such subjects and can prevent NAFLD. doi: https://doi.org/10.12669/pjms.38.1.4968 How to cite this:Ali A, Amin MJ, Ahmed MU, Taj A, Aasim M, Tabrez E. Frequency of non-alcoholic fatty liver disease (NAFLD) and its associated risk factors among Type-2 diabetics. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4968 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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