The global incidence of nonalcoholic fatty liver disease(NAFLD)is escalating considerably.NAFLD covers a range of liver conditions from simple steatosis to the more severe form known as nonalcoholic steatohepatitis,which involves chronic liver inflammation and the transformation of hepatic stellate cells into myofibroblasts that generate excess extracellular matrix,leading to fibrosis.Hepatocyte ballooning is a key catalyst for fibrosis progression,potentially advancing to cirrhosis and its decompensated state.Fibrosis is a critical prognostic factor for outcomes in patients with NAFLD;therefore,those with substantial fibrosis require timely intervention.Although liver biopsy is the most reliable method for fibrosis detection,it is associated with certain risks and limitations,particularly in routine screening.Consequently,various noninvasive diagnostic techniques have been introduced.This review examines the increasing prevalence of NAFLD,evaluates the noninvasive diagnostic techniques for fibrosis,and assesses their efficacy in staging the disease.In addition,it critically appraises current and emerging antifibrotic therapies,focusing on their mechanisms,efficacy,and potential in reversing fibrosis.This review underscores the urgent need for effective therapeutic strategies,given the dire consequences of advanced fibrosis.
Mohamed Abdel-SamieeEssam Salah IbrahimMohamed KohlaEman AbdelsameeaMohsen Salama
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in the Western world and has a strong relationship to obesity and diabetes. NAFLD has not been well studied in pregnant women. We studied a series of lean, obese, and gestational diabetic pregnant women and determined that liver enzymes would not serve to diagnose the presence of NAFLD in an obstetric population. A total of 59 pregnant women of various gestational ages and maternal weights who denied a history of alcohol intake or preexisting liver disease were recruited from a single-center university general obstetric clinic. Pregnant women underwent a maternal abdominal and obstetrical ultrasound, and blood samples were obtained for assays of liver enzymes, adiponectin and leptin. The presence of hepatic steatosis was established using standardized ultrasound criteria. NAFLD was detected by ultrasound in 48.9% of pregnant women and almost equally distributed between lean and obese women. The incidence of NAFLD in gestational diabetic pregnancies (50%) was comparable to the non-diabetic group with NAFLD in pregnant women. Adiponectin and leptin are similar between gravidas with and without NAFLD. Screening of pregnant women at any stage of pregnancy, early or late, lean or obese, or gestational diabetes after 26 weeks of gestation, would serve as a useful approach to determine NAFLD in pregnant women.
V. Daniel CastracaneGlena DavisChristopher G. MaguireUrvi ShahWilliam A. MeachumRobert P. Kauffman
Background: The objective of this study was to compare and analyze the variations in clinical indices before and after treatment of type 2 mellitus (T2DM) combined with nonalcoholic fatty liver disease (NAFLD) that were treated with glucagon-like peptide 1 receptor agonists (GLP-1RAs). Methods: The electronic medical record system was utilized to search for a total of 16 patients with type 2 diabetes complicated by NAFLD who were hospitalized at the First Affiliated Hospital of Yangtze University from October 2022 to April 2023 and treated with GLP-1RA for the first time. The clinical indices were compared before and after 12 weeks of treatment with GLP-1RA. Results: The liver-spleen CT ratio (L/S), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) in all patients treated with GLP-1RA after 12 weeks were significantly different (P 0.05). The patients were categorized into two groups based on the types of GLP-1RAs. The changes in L/S, TC, TG, and LDL-C in the long-acting group after treatment were statistically significant (P Conclusions: GLP-1RAs can improve liver function, regulate lipid metabolism, and reduce the severity of fatty liver in patients with T2DM complicated by NAFLD, which demonstrates the importance of clinical applications.
This editorial focuses on the relationship between nonalcoholic fatty pancreas disease(NAFPD)and the development and remission of type 2 diabetes(T2D).NAFPD is characterized by intrapancreatic fatty deposition associated with obesity and not associated with alcohol abuse,viral infections,and other factors.Ectopic fat deposition in the pancreas is associated with the development of T2D,and the underlying mechanism is lipotoxicβ-cell dysfunction.However,the results on the relationship between intrapancreatic fat deposition(IPFD)andβ-cell function are conflicting.Regardless of the therapeutic approach,weight loss improves IPFD,glycemia,andβ-cell function.Pancreatic imaging is valuable for clinically monitoring and evaluating the management of T2D.
