Non-alcoholic Fatty Liver in Everyday Clinical Practice: From Diagnosis to Therapy

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (18 April 2024) | Viewed by 12780

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Guest Editor
Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
Interests: non-alcoholic fatty liver disease; metabolic-associated fatty liver disease; diabetes; clinical pharmacology
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Guest Editor
Second Department of Psychiatry, Institute of Psychiatry and Neurology, Jana III Sobieskiego Street 9, 02-957 Warsaw, Poland
Interests: psychopathology; mental illness; clinical health; clinical psychiatry; clinical psychology; sleep disorders; psychological assessment; psychosomatic medicine

Special Issue Information

Dear Colleagues,

Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases encountered in everyday clinical practice. It is a very insidious disease because it often does not cause symptoms and is associated with the risk of life-threatening consequences. It has been proven that it increases the risk of liver complications (including fibrosis, cirrhosis, and hepatocellular carcinoma—HCC), metabolic complications (including type 2 diabetes and its complications), and is associated with the development of other pathologies (cardiovascular complications, including heart failure atrial fibrillation and chronic subclinical and clinical coronary syndrome), and non-HCC malignancies (including colorectal, breast, prostate, lung, and pancreatic). Recently, attention has also been paid to the relationship between NAFLD and chronic kidney disease and its impact on its severity. So far, there is an interesting discussion related to the mechanisms of development, the choice of tools for diagnosing fatty infiltration of the liver and the therapeutic standards of NAFLD. Despite the strong association of this pathology with obesity and insulin resistance, new mechanisms involved in the development of NAFLD are still being discovered. At the moment, no single marker with a highly sensitive and specific association with the presence of NAFLD has been identified, despite a wide choice (biopsy, imaging, and laboratory tests). Therefore, in the non-invasive diagnosis of this pathology, a number of helpful scales are used, taking into account the patient’s sex, age, anthropometric measurements, and selected laboratory parameters. NAFLD therapy is mainly based on appropriate diet, physical exercise, and pharmacotherapy aimed at reducing body weight. However, it should be remembered that NAFLD also occurs in thin people; therefore, the possibility of therapeutic intervention in other mechanisms of the development of this pathology is also suggested.

The purpose of our Special Issue is collecting papers, including original and review papers, related to the etiopathogenesis, diagnosis, complications, and treatment of patients with NAFLD based on current medical knowledge, which will enable the improvement of patient care in everyday clinical practice.

Dr. Kosmalski Marcin
Dr. Łukasz Mokros
Guest Editors

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Published Papers (5 papers)

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Review

21 pages, 3141 KiB  
Review
Exploring Varied Treatment Strategies for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
by Amani Elshaer, David M. H. Chascsa and Blanca C. Lizaola-Mayo
Life 2024, 14(7), 844; https://doi.org/10.3390/life14070844 - 3 Jul 2024
Cited by 3 | Viewed by 2288
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a liver disorder characterized by steatosis with underlying metabolic risk factors. The prevalence of MASLD continues to rise, leading to increased patient risk of various complications. Recent research has been focused on new therapeutic strategies to [...] Read more.
Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a liver disorder characterized by steatosis with underlying metabolic risk factors. The prevalence of MASLD continues to rise, leading to increased patient risk of various complications. Recent research has been focused on new therapeutic strategies to reduce the incidence of MASLD and provide effective treatment plans to prevent further irreversible liver damage. The treatment approach is multifactorial, with a primary focus on weight loss and management of underlying comorbidities through lifestyle modifications, pharmacotherapy, or surgical options. Ongoing research is exploring new pharmacological therapies that could enhance the treatment of MASLD. Full article
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23 pages, 1211 KiB  
Review
Platelet, Antiplatelet Therapy and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Narrative Review
by Andrea Boccatonda, Lorenza Del Cane, Lara Marola, Damiano D’Ardes, Gianfranco Lessiani, Nicoletta di Gregorio, Claudio Ferri, Francesco Cipollone, Carla Serra, Francesca Santilli and Fabio Piscaglia
Life 2024, 14(4), 473; https://doi.org/10.3390/life14040473 - 4 Apr 2024
Cited by 2 | Viewed by 2525
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is not only related to traditional cardiovascular risk factors like type 2 diabetes mellitus and obesity, but it is also an independent risk factor for the development of cardiovascular disease. MASLD has been shown to be independently [...] Read more.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is not only related to traditional cardiovascular risk factors like type 2 diabetes mellitus and obesity, but it is also an independent risk factor for the development of cardiovascular disease. MASLD has been shown to be independently related to endothelial dysfunction and atherosclerosis. MASLD is characterized by a chronic proinflammatory response that, in turn, may induce a prothrombotic state. Several mechanisms such as endothelial and platelet dysfunction, changes in the coagulative factors, lower fibrinolytic activity can contribute to induce the prothrombotic state. Platelets are players and addresses of metabolic dysregulation; obesity and insulin resistance are related to platelet hyperactivation. Furthermore, platelets can exert a direct effect on liver cells, particularly through the release of mediators from granules. Growing data in literature support the use of antiplatelet agent as a treatment for MASLD. The use of antiplatelets drugs seems to exert beneficial effects on hepatocellular carcinoma prevention in patients with MASLD, since platelets contribute to fibrosis progression and cancer development. This review aims to summarize the main data on the role of platelets in the pathogenesis of MASLD and its main complications such as cardiovascular events and the development of liver fibrosis. Furthermore, we will examine the role of antiplatelet therapy not only in the prevention and treatment of cardiovascular events but also as a possible anti-fibrotic and anti-tumor agent. Full article
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28 pages, 2798 KiB  
Review
Role of Perturbated Hemostasis in MASLD and Its Correlation with Adipokines
by Salvatore Pezzino, Tonia Luca, Mariacarla Castorina, Stefano Puleo, Saverio Latteri and Sergio Castorina
Life 2024, 14(1), 93; https://doi.org/10.3390/life14010093 - 7 Jan 2024
Cited by 3 | Viewed by 2893
Abstract
The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to rise, making it one of the most prevalent chronic liver disorders. MASLD encompasses a range of liver pathologies, from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH) with inflammation, hepatocyte damage, and fibrosis. [...] Read more.
The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to rise, making it one of the most prevalent chronic liver disorders. MASLD encompasses a range of liver pathologies, from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH) with inflammation, hepatocyte damage, and fibrosis. Interestingly, the liver exhibits close intercommunication with fatty tissue. In fact, adipose tissue could contribute to the etiology and advancement of MASLD, acting as an endocrine organ that releases several hormones and cytokines, with the adipokines assuming a pivotal role. The levels of adipokines in the blood are altered in people with MASLD, and recent research has shed light on the crucial role played by adipokines in regulating energy expenditure, inflammation, and fibrosis in MASLD. However, MASLD disease is a multifaceted condition that affects various aspects of health beyond liver function, including its impact on hemostasis. The alterations in coagulation mechanisms and endothelial and platelet functions may play a role in the increased vulnerability and severity of MASLD. Therefore, more attention is being given to imbalanced adipokines as causative agents in causing disturbances in hemostasis in MASLD. Metabolic inflammation and hepatic injury are fundamental components of MASLD, and the interrelation between these biological components and the hemostasis pathway is delineated by reciprocal influences, as well as the induction of alterations. Adipokines have the potential to serve as the shared elements within this complex interrelationship. The objective of this review is to thoroughly examine the existing scientific knowledge on the impairment of hemostasis in MASLD and its connection with adipokines, with the aim of enhancing our comprehension of the disease. Full article
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17 pages, 583 KiB  
Review
What Does Sarcopenia Have to Do with Nonalcoholic Fatty Liver Disease?
by Katarzyna Ferenc, Sara Jarmakiewicz-Czaja and Rafał Filip
Life 2024, 14(1), 37; https://doi.org/10.3390/life14010037 - 25 Dec 2023
Viewed by 2029
Abstract
Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. As the second stage of developing steatosis, nonalcoholic hepatitis (NASH) carries the risk of fibrosis, cirrhosis, and hepatocellular carcinoma. Sarcopenia is defined as a condition characterized by [...] Read more.
Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. As the second stage of developing steatosis, nonalcoholic hepatitis (NASH) carries the risk of fibrosis, cirrhosis, and hepatocellular carcinoma. Sarcopenia is defined as a condition characterized by a decrease in muscle mass and functional decline. Both NAFLD and sarcopenia are global problems. The pathophysiological mechanisms that link the two entities of the disease are insulin resistance, inflammation, nutritional deficiencies, impairment of myostatin and adiponectin, or physical inactivity. Furthermore, disorders of the gut-liver axis appear to induce the process of developing NAFLD and sarcopenia. The correlations between NAFLD and sarcopenia appear to be bidirectional, so the main objective of the review was to determine the cause-and-effect relationship between the two diseases. Full article
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13 pages, 3509 KiB  
Review
Frontiers of Collaboration between Primary Care and Specialists in the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Review
by Koki Nagai, Kazuki Nagai, Michihiro Iwaki, Takashi Kobayashi, Asako Nogami, Masanao Oka, Satoru Saito and Masato Yoneda
Life 2023, 13(11), 2144; https://doi.org/10.3390/life13112144 - 31 Oct 2023
Cited by 3 | Viewed by 2275
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is the most common liver disease. It has a rapidly growing patient population owing to the increasing prevalence of obesity and type 2 diabetes. Patients with MASLD are primarily [...] Read more.
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is the most common liver disease. It has a rapidly growing patient population owing to the increasing prevalence of obesity and type 2 diabetes. Patients with MASLD are primarily treated by family physicians when fibrosis is absent or mild and by gastroenterologists/hepatologists when fibrosis is more advanced. It is imperative that a system for the appropriate treatment and surveillance of hepatocellular carcinoma be established in order to ensure that highly fibrotic cases are not overlooked among the large number of MASLD patients. Family physicians should check for viral hepatitis, autoimmune hepatitis, alcoholic liver disease, and drug-induced liver disease, and should evaluate fibrosis using NIT; gastroenterologists/hepatologists should perform liver biopsy, ultrasound elastography (260 units in Japan as of October 2023), and MR elastography (35 units in Japan as of October 2023). This review presents the latest findings in MASLD and the role, accuracy, and clinical use of NIT. It also describes the collaboration between Japanese primary care and gastroenterologists/hepatologists in Japan in the treatment of liver diseases, including MASLD. Full article
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