Non-alcoholic fatty liver disease (NAFLD) represents a major health problem worldwide
because of its high and rising prevalence, its association with cardiovascular disease,
and its link with an increased risk of developing cirrhosis and hepatocellular carcinoma
(HCC). NAFLD is classified into different degrees, from simple steatosis (overall
20–30% prevalence), which is considered “benign”, to steatohepatitis (NASH: 2–5% prevalence)
and fibrosis.
1
,
2
The major risk factors of NAFLD include metabolic syndrome (i.e. obesity, diabetes, hypercholesterolemia and hypertriglyceridemia), sedentary lifestyle,
genetic predispositions (e.g. PNPLA3 p.I148M, TM6SF2 p.E167K and MBOAT7 rs641738) and environmental factors (e.g. Western diet).
1
,
2
,
3
Indeed, the prevalence of NAFLD/NASH in patients with obesity and/or diabetes increases
dramatically.
[2]
The differential diagnosis of NAFLD and NASH is currently available with accurate
non-invasive methods based on serum metabolomics and/or imaging approaches,
4
,
- Barr J.
- Vazquez-Chantada M.
- Alonso C.
- Perez-Cormenzana M.
- Mayo R.
- Galan A.
- et al.
Liquid chromatography-mass spectrometry-based parallel metabolic profiling of human
and mouse model serum reveals putative biomarkers associated with the progression
of nonalcoholic fatty liver disease.
J Proteome Res. 2010; 9: 4501-4512
5
and the determination and monitoring of liver fat concentration is also possible
by magnetic resonance imaging.
[6]
However, the precise determination of hepatocyte ballooning, inflammation and fibrosis
still requires histological characterization by liver biopsy. The EASL–EASD–EASO clinical
practice guidelines
[7]
recommend a Mediterranean diet and weight loss (7–10%) to obese patients, which have
been shown to significantly improve the NAFLD activity score (NAS score).
[8]
However, since lifestyle modifications are often not completely successful, current
research is aimed at unravelling the molecular mechanisms that trigger the development
and progression of NAFLD. Such advances will aid the ultimate goal of providing new
potential targets for pharmacological therapy, as well as discovering biomarkers for
prognosis and response to therapy.Keywords
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References
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Article info
Publication history
Published online: February 02, 2018
Accepted:
January 20,
2018
Received in revised form:
January 18,
2018
Received:
January 10,
2018
See Article, pages 773–782Identification
Copyright
© 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
