scholarly journals Nonalcoholic Fatty Liver Disease: Focus on New Biomarkers and Lifestyle Interventions

2021 ◽  
Vol 22 (8) ◽  
pp. 3899
Author(s):  
Maria Notarnicola ◽  
Alberto Ruben Osella ◽  
Maria Gabriella Caruso ◽  
Pasqua Letizia Pesole ◽  
Antonio Lippolis ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Lifestyle Modifications ◽  
Nonalcoholic Fatty Liver ◽  
Prognostic Implications ◽  
Noninvasive Biomarkers ◽  
New Biomarkers ◽  
Disease Focus

Nonalcoholic fatty liver disease (NAFLD) is considered a hepatic manifestation of metabolic syndrome, characterized from pathological changes in lipid and carbohydrate metabolism. Its main characteristics are excessive lipid accumulation and oxidative stress, which create a lipotoxic environment in hepatocytes leading to liver injury. Recently, many studies have focused on the identification of the genetic and epigenetic modifications that also contribute to NAFLD pathogenesis and their prognostic implications. The present review is aimed to discuss on cellular and metabolic alterations associated with NAFLD, which can be helpful to identify new noninvasive biomarkers. The identification of accumulated lipids in the cell membranes, as well as circulating cytokeratins and exosomes, provides new insights in understanding of NAFLD. This review also suggests that lifestyle modifications remain the main prevention and/or treatment for NAFLD.

scholarly journals Dietary Patterns and Components in Nonalcoholic Fatty Liver Disease (NAFLD): What Key Messages Can Health Care Providers Offer?

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2878 ◽  
Author(s):  
Kiarash Riazi ◽  
Maitreyi Raman ◽  
Lorian Taylor ◽  
Mark G. Swain ◽  
Abdel Aziz Shaheen
Keyword(s):  
Health Care ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Health Care Providers ◽  
Dietary Patterns ◽  
Fatty Liver Disease ◽  
Care Providers ◽  
Lifestyle Modifications ◽  
Nonalcoholic Fatty Liver

Nonalcoholic fatty liver disease (NAFLD) is a rising epidemic worldwide and will be the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplant within the next decade. NAFLD is considered as the hepatic manifestation of metabolic syndrome. Behaviors, such as a sedentary lifestyle and consuming a Western diet, have led to substantial challenges in managing NAFLD patients. With no curative pharmaceutical therapies, lifestyle modifications, including dietary changes and exercise, that ultimately lead to weight loss remain the only effective therapy for NAFLD. Multiple diets, including low-carbohydrate, low-fat, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean (MD) diets, have been evaluated. NAFLD patients have shown better outcomes with a modified diet, such as the MD diet, where patients are encouraged to increase the consumption of fruits and vegetables, whole grains, and olive oil. It is increasingly clear that a personalized approach to managing NAFLD patients, based on their preferences and needs, should be implemented. In our review, we cover NAFLD management, with a specific focus on dietary patterns and their components. We emphasize the successful approaches highlighted in recent studies to provide recommendations that health care providers could apply in managing their NAFLD patients.

scholarly journals Proteomic screening of plasma identifies potential noninvasive biomarkers associated with significant/advanced fibrosis in patients with nonalcoholic fatty liver disease

2020 ◽  
Vol 40 (1) ◽  
Author(s):  
Wei Hou ◽  
Michael G. Janech ◽  
Philip M. Sobolesky ◽  
Alison M. Bland ◽  
Salma Samsuddin ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Complement Component ◽  
Advanced Fibrosis ◽  
Nonalcoholic Fatty Liver ◽  
Noninvasive Biomarkers ◽  
Complement Component C8

Abstract Noninvasive biomarkers are clinically useful for evaluating liver fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD). The aim of the present study was to compare plasma proteins in patients with early nonalcoholic steatohepatitis (NASH) (F0-F1) versus NASH with significant/advanced fibrosis (F2–F4) to determine whether candidate proteins could be used as potential noninvasive biomarkers. Nineteen biopsy-proven NAFLD patients including ten early NASH patients and nine NASH patients with significant/advanced fibrosis were enrolled in the present study. High-resolution proteomics screening of plasma was performed with the SCIEX TripleTOF 5600 System. Proteins were quantified using two different software platforms, Progenesis Qi and Scaffold Q+, respectively. Progenesis Qi analysis resulted in the discovery of 277 proteins compared with 235 proteins in Scaffold Q+. Five consensus proteins (i.e. Complement component C7; α-2-macroglobulin; Complement component C8 γ chain; Fibulin-1; α-1-antichymotrypsin) were identified. Complement component C7 was three-fold higher in the NASH group with significant/advanced fibrosis (F2–F4) compared with the early NASH (F0-F1) group (q-value = 3.6E-6). Complement component C7 and Fibulin-1 are positively correlated with liver stiffness (P=0.000, P=0.002, respectively); whereas, Complement component C8 γ chain is negatively correlated (P=0.009). High levels of Complement C7 are associated with NASH with significant/advanced fibrosis and Complement C7 is a perfect classifier of patients included in this pilot study. Further studies will be needed in a larger validation cohort to confirm the utility of complement proteins as biomarkers or mechanistic determinants of NASH with significant/advanced fibrosis.

scholarly journals Recent advances in understanding and managing pediatric nonalcoholic fatty liver disease

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 377 ◽  
Author(s):  
Jennifer Vittorio ◽  
Joel E. Lavine
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Children And Adolescents ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Therapeutic Interventions ◽  
Lifestyle Modifications ◽  
Nonalcoholic Fatty Liver ◽  
Common Etiology

Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disease that can range from isolated macrovesicular hepatocellular steatosis to nonalcoholic steatohepatitis (NASH) with or without fibrosis to cirrhosis. The prevalence of NAFLD has increased over several decades, mirroring the global obesity pandemic. NAFLD currently represents the most common etiology of chronic liver disease in children and adolescents worldwide. Disease presentation in childhood strongly suggests that these children may have unique susceptibilities and more severe long-term consequences. Emerging data demonstrate that the pathogenesis of early-onset NAFLD is secondary to a complex interplay involving genetic, metabolic, environmental, and microbiological factors. Such influences may begin in utero. Dietary and lifestyle modifications remain the primary effective therapeutic interventions, although long-term efficacy is limited by poor adoption or adherence. Advances in the development and validation of non-invasive biomarkers and imaging modalities will facilitate diagnosis for affected children and adolescents and facilitate long-term natural history studies and the development of therapeutic interventions.

scholarly journals Evaluation and Diagnosis of Nonalcoholic Fatty Liver Disease/Steatohepatitis by K-Fold Validation Based on Pathology, Including Real-Time Shear Wave Elastography and Noninvasive Biomarkers

2020 ◽  
Author(s):  
Jie Zhou ◽  
Feng Yan ◽  
Jinshun Xu ◽  
Qiang Lu ◽  
Xianglan Zhu ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Shear Wave ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Nonalcoholic Fatty Liver ◽  
Noninvasive Biomarkers ◽  
Diagnostic Indicator

Abstract ObjectivesThis study aim to investigate the diagnostic accuracy of shear wave elastography (SWE) for diagnosing nonalcoholic steatohepatitis (NASH) and staging fibrosis in a cohort patients confirmed nonalcoholic fatty liver disease (NAFLD) by liver biopsy.MethodsA total of 86 NAFLD patients and 17 normal-control were enrolled. The performance of SWE to diagnose NASH and stage fibrosis was evaluated on the basis of histopathological inflammation grades and fibrosis stages according to Kleiner/Brunt et al.’s criteria classification, and compared to previous reported four noninvasive serum fibrotic scores, coupled with the k-fold-cross-validation and Delong test. Meanwhile, influence of steatosis on liver stiffness measurements (LSMs) of SWE was also studied.ResultsLSMs of SWE proved to be an excellent diagnostic indicator for detecting NASH (AUROC＝0.85), and fibrotic NASH: ≥F2 stage (AUROC＝0.92), ≥F3 stage (AUROC＝0.94) and =F4 stage (AUROC ＝0.94) with the cutoff values were 7.55, 7.65, 8.25 and 11.80 kPa, respectively. Compared with serum fibrotic scores, SWE had the highest AUROC for predicting ≥F2, ≥F3, =F4 by Delong test (all P＜0.05). No statistic differences of LSMs were found among different steatosis levels (P=0.29).ConclusionThe stiffness reconstructions based on SWE could be used to noninvasively identify NASH and stage fibrosis in NAFLD patients. Moreover, the diagnosis efficiency of LSMs on SWE could not be influenced by steatosis.

Nonalcoholic fatty liver disease

2020 ◽  
pp. 3147-3155
Author(s):  
Quentin M. Anstee ◽  
Christopher P. Day
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Disorder ◽  
Nonalcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Drug Treatments ◽  
Noninvasive Biomarkers

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder in the developed world, affecting 20 to 30% of Western adults. Nonalcoholic liver disease occurs with a range of severity from simple steatosis through nonalcoholic steatohepatitis (NASH) to fatty fibrosis and, ultimately, cirrhosis. The condition is a manifestation of the metabolic syndrome, strongly associated with obesity, insulin resistance, and dyslipidaemia. Dietary and genetic factors appear to determine susceptibility to the disease and its progression. In most patients, the condition is discovered incidentally when abnormal values of serum liver-related liver tests are reported. The diagnosis is usually one of exclusion. Liver biopsy is not always required but, in the absence of well-validated noninvasive biomarkers, remains the only way to detect steatohepatitis and accurately stage fibrosis of intermediate severity. However, biopsy is not practical in all cases and so a staged approach to patient assessment and risk stratification is advised. Treatment is directed at components of the metabolic syndrome: weight loss through diet and exercise has been shown to ameliorate disease. A range of novel pharmacological drug treatments are under evaluation.

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