Nonalcoholic Fatty Liver Disease: What Does the Primary Care Physician Need to Know?

Budd, Jeffrey; Cusi, Kenneth

doi:10.1016/j.amjmed.2020.01.007

Cited by 50 publications

(42 citation statements)

References 72 publications

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“…Elevated ALT, AST, or GGT were considered as surrogate markers of NAFLD. The range of abnormal liver enzymes are as follow: an elevated ALT was a level > 30 U/L for male and > 19 U/L for female, an increased GGT level was a level > 51 U/L for male and > 33 U/L for female [24], as well as an increased AST was a level ≥ 40 U/L [25].…”

Section: Discussionmentioning

confidence: 99%

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Changing trajectories of serum uric acid and risk of non-alcoholic fatty liver disease: a prospective cohort study

Kang

et al. 2020

J Transl Med

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Background: It is unclear the role of longitudinal trajectory of serum uric acid (SUA) on the development of nonalcoholic fatty liver disease (NAFLD). We aimed to determine whether longitudinal SUA trajectories are associated with the risk of new-onset NAFLD. Methods:We explored the relationship between SUA trajectories and NAFLD in a cohort including 3822 participants. Individual's SUA trajectories from 2012 to 2014 were defined using group-based trajectory modeling analysis in four distinct patterns: trajectory 1 (n = 991, 25.93%), trajectory 2 (n = 1421, 37.18%), trajectory 3 (n = 1156, 30.22%), and trajectory 4 (n = 254, 6.67%). The logistic regression model was used to evaluate the association between SUA changing trajectories and subsequent NAFLD until 2016. Dose-response relationship between SUA changing trajectories and NAFLD risk was evaluated through the testing of trajectory groups as a continuous variable. Results:The 2-year incidence of NAFLD was 13.27%. Compared with trajectory 1, the adjusted odds risk for NAFLD development was in a dose-response relationship as follows: 1.27 (95% CI 0.91-1.78) for trajectory 2, 1.89 (95% CI 1.29-2.75) for trajectory 3, and 2.34 (95% CI 1.43-3.83) for trajectory 4. And this dose-response relationship was not affected by age, sex, and abdominal obesity. Conclusions:Higher SUA changing trajectory is a risk factor for NAFLD. This finding highlights the importance of paying attention to SUA changing trajectory on the detection and prevention of NAFLD.

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Section: Discussionmentioning

confidence: 99%

“…Abnormal liver enzymes included raised ALT, AST, and GGT. Compared to other enzymes, ALT is the mostly liver-specific and is more commonly used as a specific marker of hepatocyte damage [25,42]. Besides, the previous study has reported that SUA is independently associated with elevated ALT, as a surrogate for NAFLD [43].…”

Section: Discussionmentioning

confidence: 99%

Changing trajectories of serum uric acid and risk of non-alcoholic fatty liver disease: a prospective cohort study

Kang

et al. 2020

J Transl Med

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“…The most critical intervention is to endorse a healthy lifestyle that promotes weight loss and control of cardiovascular risk factors ( Figure 1) [6] [7]. European and American guidelines [5] [8][9] emphasize the importance of modifying lifestyle in the absence of approved pharmacological agents for the treatment of NAFLD.…”

Section: First Step To Manage Nafld: Lifestyle Interventionmentioning

confidence: 99%

“…However, unfortunately, patients and clinicians are unaware of the potentially serious condition of NASH [8]. It has been described that up to 66% of patients over 50 years old with T2D or obesity have NASH [21], and it seems to be an additional independent risk factor for cardiovascular disease [7] Endocrinologist referral is recommended if the patient is considered to be a candidate for bariatric surgery, has advanced micro or macrovascular complications, and if HbA1C goals are not achieved after primary care intensification of the oral antidiabetic treatment [5] [27]. The HbA1C goal is individually established in order of comorbidities, life expectancy, risk of hypoglycemia, and micro and macrovascular complications [27].…”

Section: Specific Management Of Type 2 Diabetes Mellitus In Nafldmentioning

confidence: 99%

“…Pioglitazone is an agonist of the peroxisome proliferating factor-activated receptor γ (PPAR γ) that causes an improvement in insulin sensitivity and improves mitochondrial dysfunction in the hepatocytes [7]. The PIVENS [29] trial compared the use of 30 mg/day of pioglitazone with that of vitamin E and placebo for two years in patients without diabetes.…”

Section: Thiazolidinedionesmentioning

confidence: 99%

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Nonalcoholic fatty liver disease and the risk of metabolic comorbidities: how to manage in clinical practice

Perdomo

Dingianna

Escalada

et al. 2020

Polish Archives of Internal Medicine

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This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited, distributed under the same license, and used for noncommercial purposes only.

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Nonalcoholic Steatohepatitis

Grajower

2020

JAMA

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Nonalcoholic Fatty Liver Disease: What Does the Primary Care Physician Need to Know?

Cited by 50 publications

References 72 publications

Changing trajectories of serum uric acid and risk of non-alcoholic fatty liver disease: a prospective cohort study

Changing trajectories of serum uric acid and risk of non-alcoholic fatty liver disease: a prospective cohort study

Nonalcoholic fatty liver disease and the risk of metabolic comorbidities: how to manage in clinical practice

Nonalcoholic Steatohepatitis

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