Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis: The Patient and Physician Perspective

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(19), P. 6216 - 6216

Published: Sept. 26, 2023

Diagnosing and managing metabolic dysfunction-associated steatotic liver disease (MASLD) remains a major challenge in primary care due to lack of agreement on diagnostic tools, difficulty identifying symptoms determining their cause, absence approved pharmacological treatments, limited awareness the disease. However, prompt diagnosis management are critical preventing MASLD from progressing more severe forms This highlights need raise improve understanding among both patients physicians. The patient perspective is invaluable advancing our knowledge this how manage it, as perspectives have led growing recognition that experience subtle patient-reported outcomes should be incorporated into drug development. review expert opinion examine steatohepatitis physician pre-diagnosis early care, through progression advanced damage. Specifically, paper dives issues physicians experience, and, turn, what required management, including tips tools empower dealing with MASLD.

Language: Английский

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Non-alcoholic fatty liver disease in women – Current knowledge and emerging concepts

JHEP Reports, Journal Year: 2023, Volume and Issue: 5(10), P. 100835 - 100835

Published: June 29, 2023

Non-alcoholic fatty liver disease (NAFLD) is a major cause of worldwide, affecting up to 30% adults. Progression non-alcoholic steatohepatitis (NASH) key risk factor for cirrhosis, hepatocellular carcinoma and cardiovascular events. Alterations in reproductive hormones are linked the development and/or progression NAFLD/NASH women. Women with Polycystic Ovary Syndrome (PCOS) those estrogen deficiency at increased NAFLD/NASH, higher mortality rates older women compared men similar ages. currently leading indication transplantation without carcinoma. Therefore, better understanding NAFLD needed improve outcomes. In this review, we discuss hormonal non-hormonal factors contributing Furthermore, highlight areas focus clinical practice future research.

Language: Английский

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An integrated gene-to-outcome multimodal database for metabolic dysfunction-associated steatotic liver disease

Nature Medicine, Journal Year: 2023, Volume and Issue: 29(11), P. 2939 - 2953

Published: Oct. 30, 2023

Abstract Metabolic dysfunction-associated steatotic liver disease (MASLD) is the commonest cause of chronic worldwide and represents an unmet precision medicine challenge. We established a retrospective national cohort 940 histologically defined patients (55.4% men, 44.6% women; median body mass index 31.3; 32% with type 2 diabetes) covering complete MASLD severity spectrum, created secure, searchable, open resource (SteatoSITE). In 668 cases 39 controls, we generated hepatic bulk RNA sequencing data performed differential gene expression pathway analysis, including exploration gender-specific differences. A web-based browser was also developed. integrated histopathological assessments, transcriptomic 5.67 million days time-stamped longitudinal electronic health record to define disease-stage-specific signatures, pathogenic cell subpopulations master regulator networks associated adverse outcomes in MASLD. constructed 15-gene transcriptional risk score predict future decompensation events (area under receiver operating characteristic curve 0.86, 0.81 0.83 for 1-, 3- 5-year risk, respectively). Additionally, thyroid hormone receptor beta regulon activity identified as critical suppressor progression. SteatoSITE supports rational biomarker drug development facilitates approaches

Language: Английский

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Cardiovascular Morbidity and Mortality Related to Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis

Current Problems in Cardiology, Journal Year: 2023, Volume and Issue: 48(6), P. 101643 - 101643

Published: Feb. 10, 2023

Whether non-alcoholic fatty liver disease (NAFLD) is a cardiovascular (CV) risk factor debated. We performed systematic review and meta-analysis to assess the CV morbidity mortality related NAFLD in general population, determine whether comparable between lean non-lean phenotypes. searched multiple databases, including PubMed, Embase, Cochrane Library, for observational studies published through 2022 that reported of events mortality. Pooled odds ratios (ORs) 95% confidence intervals (CIs) all-cause mortality, myocardial infarction (MI), stroke, atrial fibrillation (AF), major adverse cerebrovascular (MACCE) were assessed random-effect meta-analysis. identified 33 total study population 10,592,851 individuals (mean age 53±8; male sex 50%; 2, 9%). Mean follow-up was 10±6 years. ORs respectively 1.14 (95% CI, 0.78-1.67) 1.13 0.57-2.23), indicating no significant association associated with increased MI (OR 1.6; 1.5-1.7), stroke (OR: 1.2-2.1), 1.7; 1.2-2.3), MACCE 2.3; 1.3-4.2). Compared NAFLD, 1.50; 1.1-2.0), but similar MACCE. While may not be it excess non-fatal events. Lean phenotypes exhibit distinct prognostic profiles should receive equitable clinical care.

Language: Английский

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A global action agenda for turning the tide on fatty liver disease

Hepatology, Journal Year: 2023, Volume and Issue: 79(2), P. 502 - 523

Published: Aug. 4, 2023

Background and Aims: Fatty liver disease is a major public health threat due to its very high prevalence related morbidity mortality. Focused dedicated interventions are urgently needed target prevention, treatment, care. Approach Results: We developed an aligned, prioritized action agenda for the global fatty community of practice. Following Delphi methodology over 2 rounds, large panel (R1 n = 344, R2 288) reviewed priorities using Qualtrics XM, indicating agreement 4-point Likert-scale providing written feedback. Priorities were revised between in R2, panelists also ranked within 6 domains: epidemiology, treatment care, models education awareness, patient perspectives, leadership policy. The consensus encompasses 29 priorities. In mean percentage “agree” responses was 82.4%, with all individual having at least super-majority (> 66.7% “agree”). highest-ranked included collaboration specialists primary care doctors on early diagnosis, address needs people living multiple morbidities, incorporation into relevant non-communicable strategies guidance. Conclusions: This consensus-driven multidisciplinary by providers, clinical researchers, policy experts provides path reduce improve outcomes. To implement this agenda, concerted efforts will be global, regional, national levels.

Language: Английский

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