NAFLD update: 5 reports on current tools for treatment, prediction

In the ongoing pursuit to find treatments for nonalcoholic fatty liver disease, researchers have focused on discerning which diet and exercise interventions may be the most successful, which current therapeutics such as daily use of aspirin may improve hepatic parameters, while continuing to develop prediction tools.

Healio Gastroenterology and Liver Disease presents the following reports on daily aspirin for reducing the risk of fibrosis, low-carb diet for hepatic fat loss, exercise intervention for improved hepatic and extrahepatic parameters, and a simulator tool for NAFLD prediction.

Daily aspirin use reduces risk for fibrosis progression in NAFLD

Results from a prospective study of patients with biopsy-proven nonalcoholic fatty liver disease showed that daily aspirin use correlated with less severe histologic features of fatty liver and nonalcoholic steatohepatitis and a lower risk for progression to advanced fibrosis.

“Recent experimental data suggest that aspirin is a promising anti-fibrotic strategy for NAFLD,” Tracey G. Simon, MD, from the Massachusetts General Hospital, and colleagues wrote. “Given the growing incidence and burden of NAFLD, understanding the potential antifibrotic benefits of aspirin remains an important unmet need.” Read more

Low-carb superior to low-fat diet for hepatic fat loss regardless of NAFLD

Patients who followed a Mediterranean low-carbohydrate diet showed significant reductions in hepatic fat content beyond visceral adipose tissue changes that correlated with improvements in cardiometabolic parameters, according to a study published in Journal of Hepatology.

“Previous studies have demonstrated the inter-relationship between [visceral adipose tissue (VAT)] and hepatic fat content (HFC), and indeed, increases in HFC were associated with similar metabolic abnormalities as observed for increases in VAT,” Yftach Gepner, PhD, from the Ben-Gurion University of the Negev in Israel, and colleagues wrote. To verify this relationship, the researchers sought to test which diet would best induce HFC loss independently of VAT. Read more

NAFLD linked to intrahepatic cholestasis of pregnancy

Due to significantly higher rates of steatosis and liver imaging, researchers linked intrahepatic cholestasis of pregnancy and nonalcoholic fatty liver disease.

Tatyana Kushner, MD, MSCE, from the Icahn School of Medicine at Mount Sinai in New York discussed the findings during a press conference call on behalf of co-author Erica Monrose, MD, from the Icahn School of Medicine, who will present the study at Digestive Disease Week in San Diego. Read more

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Exercise intervention for NAFLD shows promise if adherence maintained

Patients with nonalcoholic fatty liver disease who underwent a 12-week aerobic exercise intervention showed significant improvements in hepatic and extrahepatic parameters after review of paired biopsies, according to a study presented at the International Liver Congress 2019.

“There are limited pharmacological interventions for the treatment of NAFLD, so lifestyle modifications are the first line of treatment,” Philip O’Gorman, from the University of Dublin in Ireland, said during his presentation. “However, many studies report that individuals with NAFLD struggle to meet or maintain weight loss guidelines, so this poses a problem for these individuals.” Read more

NAFLD simulator offers teaching tools, risk prediction

A new, open-access simulator gives providers the tools to show natural progression of non-alcoholic fatty liver disease to their patients using personalized factors, according to an expert at the International Liver Congress.

“We developed an open-access interactive tool for patients and providers that can help them understand such long-term risks. Also, the other objective is to increase awareness of NASH and its consequences in patients,” Jagpreet Chhatwal, PhD, from Massachusetts General Hospital, said during his presentation. “We wanted to create something open access, for people by people, and we can continue to modify this model as we begin to understand the natural history of NAFLD better and as we progress with making more treatments available, they can be added later on.” Read more