Natural History of NAFLD

The epidemiology and the current burden of chronic liver disease are changing globally, with non-alcoholic fatty liver disease (NAFLD) becoming the most frequent cause of liver disease in close relationship with the global epidemics of obesity, type 2 diabetes and metabolic syndrome. The clinical phenotypes of NAFLD are very heterogeneous in relationship with multiple pathways involved in the disease progression. In the absence of a specific treatment for non-alcoholic steatohepatitis (NASH), it is important to understand the natural history of the disease, to identify and to optimize the control of factors that are involved in disease progression. In this paper we propose a critical analysis of factors that are involved in the progression of the liver damage and the occurrence of extra-hepatic complications (cardiovascular diseases, extra hepatic cancer) in patients with NAFLD. We also briefly discuss the impact of the heterogeneity of the clinical phenotype of NAFLD on the clinical practice globally and at the individual level.

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Lessons from Epidemiology: The Burden of Liver Disease

Digestive Diseases ◽

10.1159/000456580 ◽

2017 ◽

Vol 35 (4) ◽

pp. 304-309 ◽

Cited By ~ 46

Author(s):

Ian A. Rowe

Keyword(s):

Liver Disease ◽

Natural History ◽

Population Data ◽

Hcv Infection ◽

Alcoholic Fatty Liver ◽

The Metabolic Syndrome ◽

Future Burden ◽

History Of ◽

Direct Acting ◽

The Impact

Liver cirrhosis is responsible for more than 1 million deaths annually and the majority of these deaths are preventable. There is marked geographical variation in rates of mortality due to cirrhosis, and this variation in liver disease burden exemplifies the links between population risks for liver disease and mortality. The differing geographical distribution of the major risks factors for the development of liver disease including alcohol consumption, hepatitis C virus (HCV) infection, hepatitis B virus infection, and obesity and the metabolic syndrome has the potential to highlight opportunities for intervention, while the evolution of these risk factors provides insights into understanding the future burden of liver disease. This review focuses on the use of population data to identify high-risk areas and populations that would benefit from preventative interventions to reduce the mortality from liver disease. Specific strategies that are effective at the policy and public health levels are discussed to illustrate the impact these can have if widely implemented. The impact of therapies that have the potential to change the natural history of liver disease, including direct acting antivirals for HCV infection is also described. Finally, the challenges of describing the epidemiology of non-alcoholic fatty liver disease are highlighted to illustrate the need to understand the natural history of disease to inform and influence the development of novel therapies.

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Modelling the HIV-Associated TB Epidemic and the Impact of Interventions Aimed at Epidemic Control

HIV and Tuberculosis ◽

10.1007/978-3-030-29108-2_3 ◽

2019 ◽

pp. 25-55

Author(s):

P. J. Dodd ◽

C. Pretorius ◽

B. G. Williams

Keyword(s):

Natural History ◽

Mathematical Models ◽

Population Level ◽

Explicit Representation ◽

Epidemic Control ◽

Future Directions ◽

Individual Level ◽

Tuberculosis Epidemiology ◽

History Of ◽

The Impact

Abstract In this chapter, we focus on mathematical models of tuberculosis epidemiology (TB) that include interactions with HIV and an explicit representation of transmission. We review the natural history of TB and illustrate how its features are simplified and incorporated in mathematical models. We then review the ways HIV influences the natural history of TB, the interventions that have been considered in models, and the way these individual-level effects are represented in models. We then go on to consider population-level effects, reviewing the TB/HIV modelling literature. We first review studies whose focus was on purely epidemiological modelling, and then studies whose focus was on modelling the impact of interventions. We conclude with a summary of the uses and achievements of TB/HIV modelling and some suggested future directions.

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A Role for Gut Microbiome Fermentative Pathways in Fatty Liver Disease Progression

Journal of Clinical Medicine ◽

10.3390/jcm9051369 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1369 ◽

Cited By ~ 1

Author(s):

Paula Iruzubieta ◽

Juan M. Medina ◽

Raúl Fernández-López ◽

Javier Crespo ◽

Fernando de la Cruz

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Disease Progression ◽

Gut Microbiome ◽

Fatty Liver Disease ◽

Molecular Mechanisms ◽

Alcohol Fermentation ◽

Alcoholic Fatty Liver ◽

Liver Disease Progression ◽

The Impact

Non-alcoholic fatty liver disease (NAFLD) is a multifactorial disease in which environmental and genetic factors are involved. Although the molecular mechanisms involved in NAFLD onset and progression are not completely understood, the gut microbiome (GM) is thought to play a key role in the process, influencing multiple physiological functions. GM alterations in diversity and composition directly impact disease states with an inflammatory course, such as non-alcoholic steatohepatitis (NASH). However, how the GM influences liver disease susceptibility is largely unknown. Similarly, the impact of strategies targeting the GM for the treatment of NASH remains to be evaluated. This review provides a broad insight into the role of gut microbiota in NASH pathogenesis, as a diagnostic tool, and as a therapeutic target in this liver disease. We highlight the idea that the balance in metabolic fermentations can be key in maintaining liver homeostasis. We propose that an overabundance of alcohol-fermentation pathways in the GM may outcompete healthier, acid-producing members of the microbiota. In this way, GM ecology may precipitate a self-sustaining vicious cycle, boosting liver disease progression.

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Epidemiology and natural history of non-alcoholic fatty liver disease (NAFLD)

Annals of Hepatology ◽

10.1016/s1665-2681(19)31820-4 ◽

2009 ◽

Vol 8 ◽

pp. S4-S8 ◽

Cited By ~ 178

Author(s):

Stefano Bellentani ◽

Mariano Marino

Keyword(s):

Liver Disease ◽

Natural History ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

History Of ◽

Alcoholic Fatty Liver Disease

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Impact of Nutritional Changes on Nonalcoholic Fatty Liver Disease

Nutrients ◽

10.3390/nu11030677 ◽

2019 ◽

Vol 11 (3) ◽

pp. 677 ◽

Cited By ~ 28

Author(s):

Carolina M. Perdomo ◽

Gema Frühbeck ◽

Javier Escalada

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Strong Association ◽

Specific Treatment ◽

Dietary Recommendations ◽

Lifestyle Modifications ◽

Alcoholic Fatty Liver ◽

The Metabolic Syndrome ◽

The Impact

Non-alcoholic fatty liver disease (NAFLD) is a major global health threat due to its growing incidence and prevalence. It is becoming the leading cause of liver disease in addition to its strong association with cardio-metabolic disease. Therefore, its prevention and treatment are of strong public interest. Therapeutic approaches emphasize lifestyle modifications including physical activity and the adoption of healthy eating habits that intend to mainly control body weight and cardio-metabolic risk factors associated with the metabolic syndrome. Lifestyle interventions may be reinforced by pharmacological treatment in advanced stages, though there is still no registered drug for the specific treatment of NAFLD. The purpose of this review is to assess the evidence available regarding the impact of dietary recommendations against NAFLD, highlighting the effect of macronutrient diet composition and dietary patterns in the management of NAFLD.

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Meta-analysis: Natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity

Annals of Medicine ◽

10.3109/07853890.2010.518623 ◽

2010 ◽

Vol 43 (8) ◽

pp. 617-649 ◽

Cited By ~ 716

Author(s):

Giovanni Musso ◽

Roberto Gambino ◽

Maurizio Cassader ◽

Gianfranco Pagano

Keyword(s):

Liver Disease ◽

Natural History ◽

Diagnostic Accuracy ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Meta Analysis ◽

Alcoholic Fatty Liver ◽

Non Invasive ◽

History Of ◽

Alcoholic Fatty Liver Disease

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MAFLD-Epidemiology, Natural History, Outcomes and Prevention

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2021.3.4.941 ◽

2021 ◽

Vol 3 (4) ◽

pp. 12-17

Author(s):

Aimun Raees ◽

Muhammad Kamran ◽

Wasim Jafri

Keyword(s):

Liver Disease ◽

Natural History ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Lifestyle Changes ◽

Rapid Progression ◽

Metabolic Dysfunction ◽

Alcoholic Fatty Liver ◽

History Of ◽

To Come

Scientists have recently modified the term Non-Alcoholic Fatty Liver Disease (NAFLD) to Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) in an attempt to improve the understanding and overall outcomes of the disease. The leaping prevalence and formidable mortality rate of fatty liver disease throughout the world is quite worrisome. Due to the lack of appropriate knowledge of the natural history of disease, suitable pharmacotherapy could never be devised. Thus, the management solely relies on patients’ earnest co-operation with fierce lifestyle changes such as exercise, weight loss and dietary modifications. In this era, it is essential to come up with strategies to curtail the underlying risk factors in order to prevent the rapid progression of MAFLD. In this review, we will discuss the epidemiology of NAFLD and the newly found evidence on.

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Homebound by COVID19: The Benefits and Consequences of Non-Pharmaceutical Intervention Strategies

10.21203/rs.3.rs-51320/v2 ◽

2020 ◽

Author(s):

Buse Eylul Oruc ◽

Arden Baxter ◽

Pinar Keskinocak ◽

John Asplund ◽

Nicoleta Serban

Keyword(s):

School Closure ◽

Disease Spread ◽

Contact Network ◽

Population Mixing ◽

Individual Level ◽

History Of ◽

Potential Benefits ◽

The Individual ◽

The Impact ◽

Infection Spread

Abstract Background. Recent research has been conducted by various countries and regions on the impact of non-pharmaceutical interventions (NPIs) on reducing the spread of COVID19. This study evaluates the tradeoffs between potential benefits (e.g., reduction in infection spread and deaths) of NPIs for COVID19 and being homebound (i.e., refraining from interactions outside of the household).Methods. An agent-based simulation model, which captures the natural history of the disease at the individual level, and the infection spread via a contact network assuming heterogeneous population mixing in households, peer groups (workplaces, schools), and communities, is adapted to project the disease spread and estimate the number of homebound people and person-days under multiple scenarios, including combinations of shelter-in-place, voluntary quarantine, and school closure in Georgia from March 1 to September 1, 2020.Results. Compared to no intervention, under voluntary quarantine, voluntary quarantine with school closure, and shelter-in-place with school closure scenarios 4.5, 23.1, and 200+ homebound adult-days were required to prevent one infection, with the maximum number of adults homebound on a given day in the range of 119K-248K, 465K-499K, 5,388K-5,389K, respectively. Compared to no intervention, school closure only reduced the percentage of the population infected by less than 16% while more than doubling the peak number of adults homebound.Conclusions. Voluntary quarantine combined with school closure significantly reduced the number of infections and deaths with a considerably smaller number of homebound person-days compared to shelter-in-place.

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