“Because fatty liver disease is, in most cases, a silent clinical condition, without the initial signs and symptoms, along with physical and laboratory measurements,” says Johanna DiStefano. normal,” , PhD, Professor in TGen’s Fibrosis and Metabolism Program, and head of TGen’s Diabetes and Fibrosis Unit.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver condition in the United States and may affect approximately 24% of the global population. The incidence of NAFLD is increasing worldwide, making it a significant health threat. Its most severe form can progress to a condition called nonalcoholic steatohepatitis (NASH), which is characterized by inflammation of the liver and sometimes fibrosis, and can lead to cirrhosis. liver cancer and death. All are difficult to diagnose and treat.
Unexpected discovery for thin patients
One study found that – between the time they were initially diagnosed and the follow-up examination – lean people with NAFLD had a greater risk of severe liver disease than those with a higher body mass index (BMI).
Dr DiStefano said: “This unexpected finding suggests that lean people have a faster rate of fibrosis progression than those with a higher BMI.
While obesity is the strongest independent risk factor for NAFLD, even in cases of severe obesity, some people do not develop severe liver disease, suggesting a possible genetic predisposition at work; some genes promote liver disease and others protect against the condition.
For example, one study of 900 lean Japanese participants showed a twofold increased risk of NAFLD in well-studied carriers of the PNPLA3 gene.
Additionally, women are at increased risk of developing NAFLD following the menopausal transition, possibly due to hormone-related metabolic changes caused by loss of protective estrogens and other factors, the review said.
There is no consensus on screening for NAFLD
There is no global consensus on how to screen for NAFLD due to uncertain evidence supporting diagnostic tests, treatment options, cost-effectiveness, and potential long-term benefits of screening. And for lean individuals, the NAFLD guidelines are even less clear:
“Development and distribution of consistent screening and risk assessment guidelines will be critical to ensuring optimal clinical management for all NAFLD patients,” the review said.
Assessing the risk of NAFLD in lean individuals may depend on a better understanding of menopausal status, genetic factors, and ethnicity – particularly in those of Asian Indian descent and Hispanic ancestry. – alcohol intake and dietary factors, including added sugars, refined carbohydrates, saturated fats and cholesterol. A key question is whether NAFLD in lean individuals represents a distinct disease that needs to be specifically managed, as many researchers suggest, or is it a classic type of NAFLD associated with obesity that would respond. With the current approach is to lose weight and control insulin resistance, high blood pressure, and too high blood fat?
Glenn S. Gerhard, MD, Chair of the Department of Genetics and Moleculars, said: “More work is needed not only to address risk factors but also to raise awareness among practitioners about the risks. NAFLD-related underlying health in lean individuals. Biochemistry at Temple University Lewis Katz School of Medicine.
The review – NAFLD in normal-weight individuals – was funded by grants from the National Institutes of Health (NIH).