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7 recent reports on NALFD risk factors, intervention
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Several recent studies have shown that nonalcoholic fatty liver disease and nonalcoholic steatohepatitis rates are increasing steadily in the U.S. and other countries following increased trends for obesity. NAFLD and NAFLD-related complications such as liver cancer are also becoming more common indications for liver transplantation.
Healio presents the following reports on NAFLD and related complications including studies on diet and other lifestyle interventions, the effects of obesity on fibrosis development, and the correlation of modest alcohol consumption and lower fibrosis in NAFLD.
Animal protein linked to NAFLD risk in older, overweight patients
Results of a large population-based study showed that high intake of animal-derived protein correlated with nonalcoholic fatty liver disease among older, overweight Caucasians, independent of well-known risk factors.
“NAFLD is more common in people with an unhealthy lifestyle, that is, with an unhealthy diet and physical inactivity,” Louise J.M. Alferink, MD, from the University Medical Center of Rotterdam in the Netherlands, and colleagues wrote. “Although there are several hundreds of promising pharmacological trials ongoing, there is still no registered drug for the treatment of NAFLD. Therefore, in daily practice, lifestyle modification remains the first-line treatment in NAFLD.” Read more
Lifestyle intervention leads to NAFLD remission regardless of obesity
Lifestyle intervention was effective in treating nonalcoholic fatty liver disease in both patients with and without obesity, with weight reduction predicting remission of NAFLD in patients without obesity, according to data published in Journal of Hepatology.
“Lifestyle intervention is central in the management of NAFLD,” Vincent Wai-Sun Wong, MD, from the Chinese University of Hong Kong, and colleagues wrote. “A number of diets including low-carbohydrate diet, low-fat diet, low-glycemic index diet and the Mediterranean diet have been shown to improve liver enzyme levels, liver fat, and histology of NAFLD patients. Likewise, beneficial effects have been observed for both aerobic exercise and resistance training.” Read more
Emricasan improves liver function in patients with cirrhosis, high MELD
Compared with placebo, treatment with emricasan for 3 months reduced MELD scores, international normalized ratio and total bilirubin in patients with cirrhosis and MELD score 15 or higher, according to a recently published study.
“This study is a proof of concept study for this medication which may potentially reverse and stabilize decompensated cirrhosis in patients with MELD scores between 15 and 20,” Catherine T. Frenette, MD, from the Scripps Clinic in California, told Healio Gastroenterology and Liver Disease. “If this is proven to be of benefit in larger studies, then it may be an option for patients to delay the need for liver transplant, or to help those patients who cannot get a liver transplant.” Read more
NAFLD linked to higher risk for HCC
The risk for hepatocellular carcinoma was higher among patients with nonalcoholic fatty liver disease, especially those with cirrhosis, compared with the general clinical population, according to a study published in Gastroenterology.
Additionally, the absolute risk for HCC was higher than the accepted thresholds for HCC surveillance among most patients with NAFLD-related cirrhosis. Read more
Modest alcohol consumption linked to lower fibrosis in NAFLD
Modest alcohol consumption correlated with lower fibrosis among patients with nonalcoholic fatty liver disease, according to a recently published study.
“Notably, this protective association was seen in exclusive wine drinkers but not beer drinkers and was lost among subjects who consumed alcohol in a binge-type pattern,” Tim Mitchell, MBBS, from the Sir Charles Gairdner Hospital in Australia, and colleagues wrote. Read more
Obesity increases risk for fibrosis progression in fatty liver disease
Obesity and weight gain correlated with an increased risk for fibrosis progression based on aspartate aminotransferase-to-platelet ratio in a large cohort study of adults with nonalcoholic fatty liver disease.
“Weight gain during adulthood is associated with higher leptin and lower adiponectin levels, possibly leading to the development of NASH,” Yejin Kim, MD, from the Kangbuk Samsung Hospital in South Korea, and colleagues wrote. “The protective effect of weight loss against fibrosis progression may relate to fat loss, by which the adverse impacts of excess adiposity may be diminished.” Read more