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Elastography Techniques for the Assessment of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease
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Epidemiology, Pathogenesis, and Diagnostic Strategy of Diabetic Liver Disease in Japan

1
Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
2
Center of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka 564-0013, Japan
3
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(12), 4337; https://doi.org/10.3390/ijms21124337
Received: 24 April 2020 / Revised: 8 June 2020 / Accepted: 16 June 2020 / Published: 18 June 2020
(This article belongs to the Special Issue Diabetic Liver Disease)
Type 2 diabetes (T2D) is closely associated with nonalcoholic fatty liver disease (NAFLD). Nonalcoholic steatohepatitis (NASH), a severe form of NAFLD, can lead to cirrhosis, hepatocellular carcinoma (HCC), and hepatic decompensation. Patients with T2D have twice the risk of HCC incidence compared with those without T2D. Because the hepatic fibrosis grade is the main determinant of mortality in patients with NAFLD, identifying patients with advanced fibrosis using non-invasive tests (NITs) or imaging modalities is crucial. Globally, the fibrosis-4 index (FIB-4 index), NAFLD fibrosis score, and enhanced liver fibrosis test have been established to evaluate hepatic fibrosis. Two-step algorithms using FIB-4 index as first triaging tool are globally accepted. It remains unknown which kinds of NITs or elastography are best as the second step tool. In Japan, type IV collagen 7s or the CA-fibrosis index (comprising type IV collagen 7s and aspartate aminotransferase (AST)) is believed to precisely predict advanced fibrosis in NAFLD. Patients with NAFLD who have high non-invasive test results should be screened for HCC or esophageal varices. Risk factors of rapid fibrosis progression in NAFLD includes age, severe obesity, presence of T2D, menopause in women, and a patatin-like phospholipase domain containing the 3 GG genotype. Patients with NAFLD who have these risk factors should be intensively treated with lifestyle modification or pharmacotherapies for preventing liver-related mortality. View Full-Text
Keywords: hepatic fibrosis; type IV collagen 7s; hepatocellular carcinoma; patatin-like phospholipase domain containing 3 hepatic fibrosis; type IV collagen 7s; hepatocellular carcinoma; patatin-like phospholipase domain containing 3
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MDPI and ACS Style

Sumida, Y.; Shima, T.; Mitsumoto, Y.; Katayama, T.; Umemura, A.; Yamaguchi, K.; Itoh, Y.; Yoneda, M.; Okanoue, T. Epidemiology, Pathogenesis, and Diagnostic Strategy of Diabetic Liver Disease in Japan. Int. J. Mol. Sci. 2020, 21, 4337. https://doi.org/10.3390/ijms21124337

AMA Style

Sumida Y, Shima T, Mitsumoto Y, Katayama T, Umemura A, Yamaguchi K, Itoh Y, Yoneda M, Okanoue T. Epidemiology, Pathogenesis, and Diagnostic Strategy of Diabetic Liver Disease in Japan. International Journal of Molecular Sciences. 2020; 21(12):4337. https://doi.org/10.3390/ijms21124337

Chicago/Turabian Style

Sumida, Yoshio; Shima, Toshihide; Mitsumoto, Yasuhide; Katayama, Takafumi; Umemura, Atsushi; Yamaguchi, Kanji; Itoh, Yoshito; Yoneda, Masashi; Okanoue, Takeshi. 2020. "Epidemiology, Pathogenesis, and Diagnostic Strategy of Diabetic Liver Disease in Japan" Int. J. Mol. Sci. 21, no. 12: 4337. https://doi.org/10.3390/ijms21124337

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