AACE Obesity Conference 2022-Obesity Conference NAFLD Slides

Obesity Conference NAFLD Slides

Pdf Summary

NAFLD (non-alcoholic fatty liver disease) is a highly underdiagnosed and undertreated condition. It is more likely to be incidentally diagnosed rather than intentionally identified. Most patients with NAFLD are unaware of their liver disease, and there is a lack of awareness among medical providers about its prevalence in high-risk groups. High-risk patients are not being referred to hepatology, leading to underutilization of medications with proven efficacy.<br /><br />Globally, the prevalence of NAFLD is estimated to be around 25-32%, with 1.5-6.5% of the population having NASH (non-alcoholic steatohepatitis) and 1-2% having fibrosis/cirrhosis. In patients with type 2 diabetes, the prevalence of NAFLD is approximately 70%, with NASH affecting around 30-40% of these individuals.<br /><br />Diagnosis of NAFLD can be challenging, but several noninvasive tests can help assess the risk of significant fibrosis. One such test is the FIB-4 score, which combines age, AST, ALT, and platelet count. A score above 2.67 indicates a higher risk of advanced fibrosis. Other tests, such as liver elastography and biomarkers like the ELF test, can also provide valuable information.<br /><br />Management of NAFLD focuses on reducing cardiometabolic risk factors. Weight loss, through diet, exercise, or bariatric surgery, has been shown to improve various aspects of NAFLD and NASH. Medications like GLP-1 receptor agonists, pioglitazone, SGLT2 inhibitors, and statins may also be beneficial in certain cases. Vitamin E supplementation has shown improvement in liver histology but is not recommended for all patients. Bariatric surgery has demonstrated significant improvements in liver and cardiovascular outcomes for patients with NASH.<br /><br />In conclusion, addressing the fatty liver epidemic requires better awareness, diagnosis, and management of NAFLD. A multidisciplinary approach involving primary care, endocrinology, and hepatology is necessary to effectively manage this condition and reduce the associated risks.

Keywords

NAFLD

underdiagnosed

undertreated

prevalence

NASH

fibrosis/cirrhosis

type 2 diabetes

FIB-4 score

weight loss

bariatric surgery