Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Novel concepts for the diagnosis of fatty liver and personalized treatment

03.09.2018

More and more adults - but also about 34 percent of obese children - suffer from non-alcoholic fatty liver disease (NAFLD).

An unhealthy lifestyle with little physical activity and a diet high in fat, sugar and fructose and/or a genetic predisposition can be the underlying caus. However, fatty liver includes a broad spectrum of liver conditions and involves more than just the liver itself.


CVD=cardiovascular disease

HCC=hepatocellular carcinoma

NASH=non-alcoholic steatohepatitis.

Weight loss of 5-8 percent is recommended for the prevention of cardiometabolic diseases in individuals who are overweight and obese with an increased cardiometabolic risk.

Credit: IDM / Nobert Stefan

NAFLD is a complex and heterogeneous disease that can lead to various complications such as severe liver damage, type 2 diabetes and cardiovascular disease. "In order to avoid these secondary diseases, fatty liver must be diagnosed in good time, and the respective risk for diseases of the liver, the heart and other organs must be precisely assessed.

Then a personalized prevention and treatment can be developed," said first author Norbert Stefan. In recent years there have been many new findings and results in NAFLD research. It is difficult to integrate this enormous amount of new data from basic research and clinical hepatology and endocrinology research into clinical practice.

Professor Norbert Stefan and Professor Hans-Ulrich Häring - both from Tübingen University Hospital and the Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Zentrum München, a partner of the DZD, together with Professor Kenneth Cusi from the University of Florida (USA) have evaluated the most important data of NAFLD research and compiled them in a review article. The authors propose the use of new diagnostic and therapeutic approaches in the clinic to enable a specific risk prognosis for possible secondary diseases.

"Not only patients with elevated liver enzymes should be examined for fatty liver, but also people with a disproportionate fat distribution, i.e. a high proportion of abdominal fat and/or a low proportion of fat around the hips and legs," said Hans-Ulrich Häring. In addition, the authors of the review recommend fatty liver screening also for people suffering from insulin resistance or type 2 diabetes.

But how can the fat content in the liver be accurately determined and how can liver damage such as inflammation and fibrosis be reliably detected? The use of simple indices or ultrasound examinations is suitable for this in primary care. Specialists such as hepatologists, endocrinologists and radiologists could perform further examinations such as special magnetic resonance imaging (MRI) if required.

If patients suffer from fatty liver, positive effects can often be achieved with lifestyle intervention. For example, a reduction of about five percent in weight can reduce the fat content in the liver by up to 30 percent. However, to reduce the risk of liver inflammation and fibrosis, a weight loss of about ten percent is required.

"If such weight loss cannot be achieved or is insufficient to improve NAFLD, pharmacological treatment should be considered," said Cusi. To date, no drug has been approved for NAFLD. "However, under certain conditions such as diabetes and NAFLD or obesity and NAFLD, specific drugs can be used that have different effects on liver fat content, inflammation and fibrosis," Cusi went on to say.

Recent research suggests that genetic NAFLD is associated with a higher risk of liver fibrosis and liver cancer. "However, unexpectedly, the same patients have a low risk of cardiovascular diseases. In order to be able to treat those affected patients properly, it is important to know whether a fatty liver is genetically determined", Stefan mentioned

The authors of the review believe that in the future, the application of these concepts will enable a personalized risk prognosis and individualized treatment of NAFLD. In addition, researchers will be able to specifically develop lifestyle modification programs and drugs for the respective subtypes based on the various aspects of this disease.

###

Original publication: Norbert Stefan, Hans-Ulrich Häring, Kenneth Cusi. Non-alcoholic fatty liver disease: causes, cardiometabolic consequences, and treatment strategies. The Lancet Diabetes & Endocrinology 2018, DOI: 10.1016/S2213-8587(18)30154-2

Media contact for inquiries about the current publication
Norbert Stefan, MD, PhD
Professor of Medicine
Heisenberg Professorship of clinical and experimental Diabetology
University of Tübingen
Otfried-Müller-Straße 10,
72076 Tübingen, Germany
Phone: +49 (0)7071 2980390
norbert.stefan@med.uni-tuebingen.de

Kenneth Cusi, M.D., F.A.C.P., F.A.C.E.
Professor of Medicine
Chief, Division of Endocrinology, Diabetes and Metabolism
University of Florida
1600 SW Archer Rd; room H -2
Gainesville, FL 32610-0226
Phone: 352-273-8662/7840
Email: Kenneth.Cusi@medicine.ufl.edu

Post-embargo link for journalists: http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30154-2/fulltext

Birgit Niesing | EurekAlert!
Further information:
https://www.dzd-ev.de/en/press/press-releases/press-releases-2018/novel-concepts-for-the-diagnosis-of-fatty-liver-and-personalized-treatment-a-review-and-recommendations/index.html

Further reports about: Diabetes NAFLD fatty liver fibrosis inflammation liver damage type 2 diabetes weight loss

More articles from Health and Medicine:

nachricht The FiTS app now offering cooking videos as it expands its concept for long-term behavior modification
18.09.2018 | vitaliberty GmbH

nachricht The microbiota in the intestines fuels tumour growth
18.09.2018 | Technische Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Patented nanostructure for solar cells: Rough optics, smooth surface

Thin-film solar cells made of crystalline silicon are inexpensive and achieve efficiencies of a good 14 percent. However, they could do even better if their shiny surfaces reflected less light. A team led by Prof. Christiane Becker from the Helmholtz-Zentrum Berlin (HZB) has now patented a sophisticated new solution to this problem.

"It is not enough simply to bring more light into the cell," says Christiane Becker. Such surface structures can even ultimately reduce the efficiency by...

Im Focus: New soft coral species discovered in Panama

A study in the journal Bulletin of Marine Science describes a new, blood-red species of octocoral found in Panama. The species in the genus Thesea was discovered in the threatened low-light reef environment on Hannibal Bank, 60 kilometers off mainland Pacific Panama, by researchers at the Smithsonian Tropical Research Institute in Panama (STRI) and the Centro de Investigación en Ciencias del Mar y Limnología (CIMAR) at the University of Costa Rica.

Scientists established the new species, Thesea dalioi, by comparing its physical traits, such as branch thickness and the bright red colony color, with the...

Im Focus: New devices based on rust could reduce excess heat in computers

Physicists explore long-distance information transmission in antiferromagnetic iron oxide

Scientists have succeeded in observing the first long-distance transfer of information in a magnetic group of materials known as antiferromagnets.

Im Focus: Finding Nemo's genes

An international team of researchers has mapped Nemo's genome

An international team of researchers has mapped Nemo's genome, providing the research community with an invaluable resource to decode the response of fish to...

Im Focus: Graphene enables clock rates in the terahertz range

Graphene is considered a promising candidate for the nanoelectronics of the future. In theory, it should allow clock rates up to a thousand times faster than today’s silicon-based electronics. Scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) and the University of Duisburg-Essen (UDE), in cooperation with the Max Planck Institute for Polymer Research (MPI-P), have now shown for the first time that graphene can actually convert electronic signals with frequencies in the gigahertz range – which correspond to today’s clock rates – extremely efficiently into signals with several times higher frequency. The researchers present their results in the scientific journal “Nature”.

Graphene – an ultrathin material consisting of a single layer of interlinked carbon atoms – is considered a promising candidate for the nanoelectronics of the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

One of the world’s most prominent strategic forums for global health held in Berlin in October 2018

03.09.2018 | Event News

4th Intelligent Materials - European Symposium on Intelligent Materials

27.08.2018 | Event News

LaserForum 2018 deals with 3D production of components

17.08.2018 | Event News

 
Latest News

Making better use of enzymes: a new research project at Jacobs University

19.09.2018 | Life Sciences

Light provides spin

19.09.2018 | Physics and Astronomy

Enjoying virtual-reality-entertainment without headache or motion sickness

19.09.2018 | Information Technology

VideoLinks
Science & Research
Overview of more VideoLinks >>>