The global epidemiology of nonalcoholic steatohepatitis (NASH) and associated risk factors–A targeted literature review

Dufour, Jean–François; Scherer, Roger Lima; Balp, Maria‐Magdalena; McKenna, Sarah Jane; Janssens, Nico; López, Patricia; Pedrosa, Marcos

doi:10.1016/j.endmts.2021.100089

Cited by 51 publications

(36 citation statements)

References 40 publications

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“…The global prevalence of NAFLD among general population ranged from 11.2% -37.2%). Similar ranges were shown of biopsy-confirmed nonalcoholic steatohepatitis (NASH) among NAFLD subjects ranging from 15.9% to 68.3% [3]. Prevalence of NAFLD in the Asian population was reported as 31% [4].…”

Section: Introductionsupporting

confidence: 54%

Association of IRS1 (Gly972Arg) and IRS2 (Gly1057Asp) genes polymorphisms with OSA and NAFLD in Asian Indians

Bhatt

Guleria

2021

PLoS ONE

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Aim and objective The aim of the study was to investigate the relationships between insulin receptor substrate (IRS) 1 (Gly972Arg) and IRS2 (Gly1057Asp) genes with obstructive sleep apnea (OSA) and non-alcoholic fatty liver disease (NAFLD) in Asian Indians. Method A total of 410 overweight/obese subjects (130 with OSA with NAFLD, 100 with OSA without NAFLD, 95 without OSA and with NAFLD and 85 without OSA and without NAFLD) were recruited. Degree of NAFLD was based on liver ultrasound and of OSA on overnight polysomnography. Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism and confirmed by gene sequencing. Result Mean values of blood pressure, body fat markers, blood glucose, lipids, liver function, and markers of insulin resistance were significantly increased in OSA and NAFLD subjects (p<0.05). In addition, according to age (years) categories, blood pressure, blood glucose, lipids, obesity markers, and markers of insulin resistance were significantly higher in 45–60 years group as compared to 20–45 years group (p<0.05). In IRS1 gene, the genotype frequency (%) of Arg/Arg was significantly higher in NAFLD and OSA subjects. In addition, Gly/Arg genotype of IRS1 gene was associated with significantly higher body mass index, fat mass, %body fat, triglycerides, cholesterol, alkaline phosphate, aspartate transaminase, fasting insulin and HOMA-IR levels in OSA and NAFLD subjects. No significant difference in genotype frequencies of IRS2 was observed between four groups. Further we found that subjects carrying IRS1 Gly/Arg (OR 4.49, 95% C.I. 1.06–12.52, p = 0.002) genotype possess a much higher risk of OSA and NAFLD compared to IRS2 Gly/Asp (OR 1.01, 95% C.I. 0.8–2.56, p = 0.05). In sub group analysis of IRS1 Gly/Arg have significant differences between the mild, moderate and severe group (P<0.05). In addition, patients with the ‘Gly’ allele were inclined to develop more severe OSA. Conclusion We concluded that Asian Indian subject carrying the allele Gly972Arg polymorphism of IRS1 is predisposed to develop OSA and NAFLD.

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Section: Introductionsupporting

confidence: 54%

Association of IRS1 (Gly972Arg) and IRS2 (Gly1057Asp) genes polymorphisms with OSA and NAFLD in Asian Indians

Bhatt

Guleria

2021

PLoS ONE

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“…Previous investigations have clearly determined risk factors for the development of more severe COVID-19 disease and death, such as older age, male sex, increased blood pressure, presence of metabolic derangements such as diabetes and obesity, as well as some biochemical indicators (2)(3)(4)(5)(6)(7). Obese patients are more likely to have fatty liver, which has been previously recognised as a risk factor for further deterioration of the metabolic profile of the affected individuals who are not COVID-19 patients [8,33]. Given the shared risk factors between NAFLD and severe COVID-19 disease, a more severe course of COVID-19 might hypothetically be expected amongst patients with fatty liver.…”

Section: Discussionmentioning

confidence: 99%

“…Bilirubin, AST, ALT, GGT and ALP were elevated in 11.5%, 55.3%, 42.4%, 44.2% and 6% patients, respectively. Median time from the initial COVID-19 symptoms to admission was 5 days IQR (1)(2)(3)(4)(5)(6)(7)(8)(9). All patients required oxygen supplementation, including 24/217 (11.1%) patients who required HFNC.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Non-alcoholic fatty liver disease (NAFLD) is considered the liver manifestation of the metabolic syndrome that includes concomitant presence of obesity, hypertension, diabetes mellitus and dyslipidaemia. NAFLD affects around 25% of adults worldwide, with even greater prevalence among obese individuals (>50%) and those having additional metabolic conditions [ 8 , 9 ]. In line with these facts, the presence of fatty liver might be assumed as the risk factor for more severe forms of COVID-19 and adverse outcomes [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19

Zelenika

Lucijanić

Bokun

et al. 2021

JCM

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Background: Liver involvement in Coronavirus disease 2019 (COVID-19) has been recognised. We aimed to investigate the correlation of non-invasive surrogates of liver steatosis, fibrosis and inflammation using transient elastography (TE) and FibroScan-AST (FAST) score with (a) clinical severity and (b) 30-day composite outcome of mechanical ventilation (MV) or death among patients hospitalized due to COVID-19. Method: Patients with non-critical COVID-19 at admission were included. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed by TE. Clinical severity of COVID-19 was assessed by 4C Mortality Score (4CMS) and need for high-flow nasal cannula (HFNC) oxygen supplementation. Results: 217 patients were included (66.5% males, median age 65 years, 4.6% with history of chronic liver disease). Twenty-four (11.1%) patients met the 30-day composite outcome. Median LSM, CAP and FAST score were 5.2 kPa, 274 dB/m and 0.31, respectively, and neither was associated with clinical severity of COVID-19 at admission. In multivariate analysis FAST > 0.36 (OR 3.19, p = 0.036), 4CMS (OR 1.68, p = 0.002) and HFNC (OR 7.03, p = 0.001) were independent predictors of adverse composite outcome. Conclusion: Whereas LSM and CAP failed to show correlation with COVID-19 severity and outcomes, FAST score was an independent risk factor for 30-day mortality or need for MV.

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“…Despite the Global Health Sector Strategy on Viral Hepatitis 2016–2021 being launched by the World Health Organization, which aims at reducing new HCV infections by 90% and reducing deaths due to viral hepatitis by 65% by 2030, these goals will probably not be reached by the defined deadlines, and the current situation with the COVID-19 pandemic further compromises the achievement of these goals [ 8 , 9 ]. In the meantime, obesity, which is another global pandemic, has also been well recognized as a significant global health threat, not only for cardiovascular morbidity and mortality but also as an important cause of chronic liver disease (CLD) [ 10 , 11 ]. NAFLD due to overweight/obesity, in association with type 2 diabetes, arterial hypertension and dyslipidemia, is by far the most important etiology of this silent pandemic, for which reason, some authors proposed an alternative term: metabolic-associated fatty liver disease (MAFLD) [ 11 , 12 ].…”

Section: Epidemiologymentioning

confidence: 99%

Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease: From Epidemiology to Diagnostic Approach

Grgurević

Božin

Mikuš

et al. 2021

Cancers

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Non-alcoholic fatty liver disease (NAFLD) is becoming the leading cause of liver morbidity worldwide and, as such, represents the pathogenic background for the increasing incidence of hepatocellular carcinoma (HCC). The annual incidence of NAFLD-related HCC is expected to increase by 45–130% by 2030. Diabetes mellitus is the most important risk factor for HCC development in NAFLD, with the risk further increased when associated with other metabolic traits, such as obesity, arterial hypertension and dyslipidemia. The highest risk of HCC exists in patients with advanced fibrosis or cirrhosis, although 20–50% of HCC cases arise in NAFLD patients with an absence of cirrhosis. This calls for further investigation of the pathogenic mechanisms that are involved in hepatocarcinogenesis, including genetics, metabolomics, the influence of the gut microbiota and immunological responses. Early identification of patients with or at risk of NAFLD is of utmost importance to improve outcomes. As NAFLD is highly prevalent in the community, the identification of cases should rely upon simple demographic and clinical characteristics. Once identified, these patients should then be evaluated for the presence of advanced fibrosis or cirrhosis and subsequently enter HCC surveillance programs if appropriate. A significant problem is the early recognition of non-cirrhotic NAFLD patients who will develop HCC, where new biomarkers and scores are potential solutions to tackle this issue.

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The global epidemiology of nonalcoholic steatohepatitis (NASH) and associated risk factors–A targeted literature review

Cited by 51 publications

References 40 publications

Association of IRS1 (Gly972Arg) and IRS2 (Gly1057Asp) genes polymorphisms with OSA and NAFLD in Asian Indians

Association of IRS1 (Gly972Arg) and IRS2 (Gly1057Asp) genes polymorphisms with OSA and NAFLD in Asian Indians

FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19

Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease: From Epidemiology to Diagnostic Approach

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