Nonalcoholic Fatty Liver Disease

From patient-reported outcomes in clinical trials of emerging therapeutics to seeking underserved communities in the fight to eliminate hepatitis C and provide better treatment for nonalcoholic fatty liver disease, it is critical for treating physicians to remember they are treating more than a disease and its symptoms.

Nonalcoholic fatty liver disease — and its more severe stage, nonalcoholic steatohepatitis, in particular — has surpassed alcoholism as a cause of cirrhosis and is on its way to becoming the No. 1 reason for liver transplantation in the United States. It is frequently associated with obesity, insulin resistance, diabetes and other metabolic risk factors.

Healio Gastroenterology and Liver Disease presents the following reports on the most recent research on the esophagus and GERD.

Excitement has peaked this year for potential nonalcoholic steatohepatitis therapies as many more studies have revealed positive outcomes in either resolution of nonalcoholic steatohepatitis without worsening of fibrosis or reduction in fibrosis stage without worsening of nonalcoholic steatohepatitis.

SAN ANTONIO — A comprehensive gastroenterologist-supervised weight management program that includes nutrition education and behavioral support groups may lead to significant weight loss in obese patients with non-alcoholic fatty liver and GERD, according to findings presented at the American College of Gastroenterology Annual Meeting.

A novel combinations of glycans, lipids and hormonal variables can simultaneously diagnose the presence of nonalcoholic fatty liver or nonalcoholic steatohepatitis with up to 90% accuracy, according to findings published in Metabolism Clinical and Experimental.

Screening patients for NAFLD or NASH is an area largely underestimated in primary care and clinical endocrinology, mainly due to a lack of appropriate diagnostic and therapeutic tools.

Nonalcoholic fatty liver disease, or NAFLD, a condition traditionally treated by hepatologists, is widespread and frequently associated with obesity, insulin resistance, diabetes and other metabolic risk factors. Type 2 diabetes appears to worsen the course of NAFLD and promote development of nonalcoholic steatohepatitis, or NASH, the more severe form of the disease, as well as increase risks for cirrhosis and hepatocellular carcinoma. Liver disease similarly makes diabetes management more challenging. At least half of all individuals with type 2 diabetes also have NAFLD, setting the stage for a worse metabolic profile and greater cardiovascular risks. Currently, there are no drugs approved to treat NAFLD.

The top stories in endocrinology last week focused on how artificial intelligence, or AI, could be a game-changer in predicting nonalcoholic fatty liver disease and detecting thyroid nodules.

Results from the phase 2 ATLAS study showed that neither monotherapy nor combined therapy with cilofexor reached the endpoint of significant improvement in fibrosis stage without worsening of nonalcoholic steatohepatitis, according to a press release from Gilead Sciences.