EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)

Journal of Hepatology, Journal Year: 2024, Volume and Issue: 81(3), P. 492 - 542

Published: June 7, 2024

Language: Английский

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Effects of dietary intervention on human diseases: molecular mechanisms and therapeutic potential

Signal Transduction and Targeted Therapy, Journal Year: 2024, Volume and Issue: 9(1)

Published: March 11, 2024

Abstract Diet, serving as a vital source of nutrients, exerts profound influence on human health and disease progression. Recently, dietary interventions have emerged promising adjunctive treatment strategies not only for cancer but also neurodegenerative diseases, autoimmune cardiovascular metabolic disorders. These demonstrated substantial potential in modulating metabolism, trajectory, therapeutic responses. Metabolic reprogramming is hallmark malignant progression, deeper understanding this phenomenon tumors its effects immune regulation significant challenge that impedes eradication. Dietary intake, key environmental factor, can tumor metabolism. Emerging evidence indicates might affect the nutrient availability tumors, thereby increasing efficacy treatments. However, intricate interplay between pathogenesis other diseases complex. Despite encouraging results, mechanisms underlying diet-based remain largely unexplored, often resulting underutilization management. In review, we aim to illuminate various interventions, including calorie restriction, fasting-mimicking diet, ketogenic protein restriction high-salt high-fat high-fiber aforementioned diseases. We explore multifaceted impacts these encompassing their immunomodulatory effects, biological impacts, molecular mechanisms. This review offers valuable insights into application therapies

Language: Английский

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EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Obesity Facts, Journal Year: 2024, Volume and Issue: 17(4), P. 374 - 444

Published: Jan. 1, 2024

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty (NAFLD), is defined as (SLD) in the presence of one or more cardiometabolic risk factor(s) and absence harmful alcohol intake. The spectrum MASLD includes steatosis, metabolic steatohepatitis (MASH, NASH), fibrosis, cirrhosis MASH-related hepatocellular carcinoma (HCC). This joint EASL-EASD-EASO guideline provides an update on definitions, prevention, screening, diagnosis treatment for MASLD. Case-finding strategies with using non-invasive tests, should be applied individuals factors, abnormal enzymes, and/or radiological signs hepatic particularly type 2 diabetes (T2D) obesity additional factor(s). A stepwise approach blood-based scores (such FIB-4) and, sequentially, imaging techniques transient elastography) suitable to rule-out/in advanced which predictive liver-related outcomes. In adults MASLD, lifestyle modification - including weight loss, dietary changes, physical exercise discouraging consumption well optimal management comorbidities use incretin-based therapies (e.g. semaglutide, tirzepatide) T2D obesity, if indicated advised. Bariatric surgery also option obesity. If locally approved dependent label, non-cirrhotic MASH significant fibrosis (stage ≥2) considered a MASH-targeted resmetirom, demonstrated histological effectiveness acceptable safety tolerability profile. No pharmacotherapy can currently recommended cirrhotic stage. Management adaptations drugs, nutritional counselling, surveillance portal hypertension HCC, transplantation decompensated cirrhosis.

Language: Английский

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Gut-liver axis: Pathophysiological concepts and medical perspective in chronic liver diseases

Seminars in Immunology, Journal Year: 2024, Volume and Issue: 71, P. 101859 - 101859

Published: Jan. 21, 2024

Language: Английский

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Epidemiology, screening, and co-management of type 2 diabetes mellitus and metabolic dysfunction–associated steatotic liver disease

Hepatology, Journal Year: 2024, Volume and Issue: unknown

Published: May 8, 2024

Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as NAFLD, is increasingly recognized a prevalent global burden. Type 2 diabetes mellitus (T2DM), another important metabolic disease, considered major contributor to the development of MASLD. MASLD and T2DM have strong association with each other due shared pathogenic mechanisms. The co-existence diseases increases risk liver-related adverse outcomes imposes heavier burden on extrahepatic outcomes, representing substantial public health issue. Effective assessment management combined necessitate multidisciplinary approach. emergence numerous RCTs has shed light treatment This review uncovers epidemiology intertwined MASLD, offers insights into evaluation hepatic fibrosis in patients T2DM, glucose monitoring population, provides comprehensive co-management strategies for addressing both diseases.

Language: Английский

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Effects of lifestyle intervention on adults with metabolic associated fatty liver disease: A systematic review and meta-analysis

Frontiers in Endocrinology, Journal Year: 2023, Volume and Issue: 14

Published: Feb. 16, 2023

Introduction This systematic review and meta-analysis evaluates the overall effects of lifestyle interventions upon hepatic fat content metabolism-related indicators among adults with metabolic associated fatty liver disease. Methods It was registered under PROSPERO (CRD42021251527). We searched PubMed, EMBASE, MEDLINE, Cochrane, CINAHL, Scopus, CNKI, Wan-fang, VIP, CBM from inception each database to May 2021 for RCT studies on indicators. used Review Manager 5.3 text detailed tabular summaries when heterogeneity existed. Results Thirty-four 2652 participants were included. All obesity, 8% whom also had diabetes, none lean or normal weight. Through subgroup analysis, we found low carbohydrate diet, aerobic training resistance significantly improved level HFC, TG, HDL, HbA1c, HOMA-IR. Moreover, diet is more effective in improving HFC than better reduction TG (SMD, -0.25, 95% CI, -0.45 -0.06; SMD, 0.24, 0.03 0.44, respectively). Discussion Overall, this first that systematically synthesizes focused various MAFLD. The data generated applicable obesity MAFLD rather weight Systematic Registration https://www.crd.york.ac.uk/prospero/ , identifier

Language: Английский

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Management of Metabolic-Associated Fatty Liver Disease/Metabolic Dysfunction-Associated Steatotic Liver Disease: From Medication Therapy to Nutritional Interventions

Nutrients, Journal Year: 2024, Volume and Issue: 16(14), P. 2220 - 2220

Published: July 11, 2024

Non-alcoholic fatty liver disease (NAFLD) is a common long-lasting that affects millions of people around the world. It best identified with hepatic fat build-up ultimately leads to inflammation and damage. The classification nomenclature NAFLD have long been controversial topic, until 2020 when group international experts recommended substituting MAFLD (metabolic dysfunction-associated FLD). was then terminologically complemented in 2023 by altering it MASLD, i.e., metabolic steatotic (MASLD). Both MASLD terminologies comprise element disorder, as they offer diagnostic benchmarks are embedded risk factors underlie disease. (as multisystemic disease) provides comprehensive definition includes larger population patients who at morbidity mortality, well adverse cardiovascular diabetes outcomes. highlights risks lean or normal weight individuals, factor has not accentuated discussed previous guidelines. Novel antihyperglycemic agents, anti-hyperlipidemic drugs, lifestyle modifications, nutritional interventions, exercise therapies extensively studied MASLD. Nutrition plays vital role managing both conditions, where centralizing on diet rich whole vegetables, fruits, foods, healthy fats, proteins, specific nutrients (e.g., omega-3 acids fibers) can improve insulin resistance reduce inflammation. Thus, essential understand nutrition these conditions work develop an individualized plan for optimal health. This review discusses prevention strategies NAFLD/MAFLD/MASLD management, particular attention correction.

Language: Английский

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Practical Lifestyle Management of Nonalcoholic Fatty Liver Disease for Busy Clinicians

Diabetes Spectrum, Journal Year: 2024, Volume and Issue: 37(1), P. 39 - 47

Published: Feb. 1, 2024

Weight loss achieved through a combination of healthy eating patterns that encompass the principles Mediterranean diet and regular physical activity is most evidence-based treatment for nonalcoholic fatty liver disease. Although other types diets have demonstrated efficacy in fat reduction, confers additional cardiometabolic benefits. Macronutrient composition, food choices, timing can be tailored to individual preferences, culture, financial circumstances; however, recommended are characterized by minimally processed or unprocessed foods (vegetables, legumes, nuts seeds, fruits, whole grains, meats fish) low sugar, refined carbohydrates, saturated high fiber, polyphenols, vitamins, minerals, fats. Physical independently improve steatosis, prevent fibrosis cirrhosis, reduce mortality.

Language: Английский

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Effects of Selected Food Additives on the Gut Microbiome and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Medicina, Journal Year: 2025, Volume and Issue: 61(2), P. 192 - 192

Published: Jan. 22, 2025

The purpose of this article is to present selected food additives as disruptors normal intestinal homeostasis with a potential impact on the development metabolic dysfunction-associated steatotic liver disease (MASLD). A comprehensive literature search was conducted in three major electronic databases: PubMed, ScienceDirect, and Google Scholar. MASLD prevalent condition that closely related global rise obesity. Its pathogenesis multifactorial, genetic, environmental, factors playing key role. “multiple-hit” hypothesis suggests Western-style diet, rich ultra-processed foods, saturated fats, additives, combined low physical activity, contributes obesity, which promotes lipid accumulation liver. Recent studies underscore role impaired MASLD. Food including preservatives, emulsifiers, sweeteners, affect gut health function. Selected preservatives inhibit pathogenic microorganisms but disrupt microbiota, leading changes permeability dysfunction. Some emulsifiers thickeners can cause inflammation alter microbiome, contributing steatosis. Furthermore, use sweeteners such sucralose aspartame has been linked metabolism microbial composition, turn disorders.

Language: Английский

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Overview and prospect of NAFLD: Significant roles of nutrients and dietary patterns in its progression or prevention

Hepatology Communications, Journal Year: 2023, Volume and Issue: 7(10)

Published: Sept. 27, 2023

NAFLD is the most common chronic liver disease worldwide, characterized by lipid accumulation in liver, and usually evolves from steatohepatitis to fibrosis, cirrhosis, or even HCC. Its incidence rapidly rising parallel with increasing prevalence of obesity metabolic syndrome. Current therapies are limited lifestyle changes including dietary intervention exercise, which modification exerts an important part losing weight preventing NAFLD. In this review, we briefly discuss roles mechanisms components fructose, non-nutritive sweeteners, fat, proteins, vitamins progression prevention We also summarize several popular patterns such as calorie-restricted diets, intermittent fasting, ketogenic Mediterranean approach stop hypertension diets compare effects low-fat low-carbohydrate development Moreover, potential drugs targeting metabolic-related targets

Language: Английский

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