NAFLD is now present in 17% to 33% of Americans, has a worldwide distribution, and parallels the frequency of central adiposity, obesity, insulin resistance, metabolic syndrome and type 2 diabetes. NASH could be present in one third of NAFLD cases. [ncbi.nlm.nih.gov]

• Weight Loss

  However, the overall effect of weight loss on nonalcoholic fatty liver disease (NAFLD) remains unclear. This systematic review and meta-analysis is an effort to explore the effect of weight loss after bariatric surgical procedures on NAFLD. [ncbi.nlm.nih.gov]

• Weight Gain

  Due to progressive fatigue, he underwent an orthotopic liver transplantation complicated by a 36-kg weight gain. Sixteen months posttransplantation, a liver biopsy revealed the recurrence of NASH. [ncbi.nlm.nih.gov]

  However, the side-effects associated with these drugs, which include osteopenia, increased fracture risk, fluid retention, congestive heart failure, bladder cancer, and long-term weight gain, have limited their adoption. [en.wikipedia.org]

  After one weight-gain/weight-loss cycle, mice exhibited a loss in microbial isoflavonoid and steroid biosynthesis metagenomic function that led to exacerbated weight regain, body fat, and lower energy expenditure upon reintroducing HFD. [doi.org]

• Fatigue

  Due to progressive fatigue, he underwent an orthotopic liver transplantation complicated by a 36-kg weight gain. Sixteen months posttransplantation, a liver biopsy revealed the recurrence of NASH. [ncbi.nlm.nih.gov]

  However, some have fatigue, malaise, or right upper quadrant abdominal discomfort. Hepatomegaly develops in about 75% of patients. [msdmanuals.com]

• Asymptomatic

  Patients with cirrhosis due to NASH can be asymptomatic and may lack the usual signs of chronic liver disease. [msdmanuals.com]

  At the least advanced end of the spectrum, non-alcoholic fatty liver (NAFL) is an excess of fat in the liver (steatosis) present in 20-30% of the general population and is largely asymptomatic. 1 2 3 4 Currently, diagnosis of NAFLD is most commonly made [doi.org]

  […] in Vienna, Dr Kushala Abeysekera, from the University of Bristol, said: “We were concerned to find that, at only 24 years of age, one in five had steatosis and one in 40 had evidence of fibrosis, based on elastography results, in a group of largely asymptomatic [theguardian.com]

  This is challenging as most children with NAFLD are asymptomatic with only 42-59% showing abdominal pain. [en.wikipedia.org]

• Right Upper Quadrant Pain

  His postoperative course was complicated by a 50-kg weight loss and continued right upper quadrant pain. Repeat liver biopsy revealed NASH with accompanying micronodular cirrhosis. [ncbi.nlm.nih.gov]

  Other symptoms might be present, such as right upper quadrant pain or acanthosis nigricans, the latter being frequently observed in NASH patients, or hepatomegaly found in 30–40% of children with NAFLD.Liver biopsies for diagnosis in children should be [en.wikipedia.org]

• Nausea

  Three weeks after sorafenib therapy, at Eastern Cooperative Oncology Group performance status 3, he developed jaundice, general weakness, flapping tremor, nausea, and anorexia. [ncbi.nlm.nih.gov]

  Severe fatty infiltration of the liver can result in symptoms of malaise, weakness, anorexia, nausea, and abdominal discomfort. Jaundice is present in 15% of patients admitted to the hospital. [emedicine.com]

• Abdominal Pain

  This is challenging as most children with NAFLD are asymptomatic with only 42-59% showing abdominal pain. [en.wikipedia.org]

• Heart Disease

  OBJECTIVE: Preliminary data suggest that nonalcoholic fatty liver disease is associated with early heart failure (HF). [ncbi.nlm.nih.gov]

  Obesity is a risk factor for many chronic conditions including diabetes, hypertension, hypercholesterolemia, stroke, heart disease, certain cancers, and arthritis. [doi.org]

  […] as well as non-liver related disease such as ischaemic heart disease. [dx.doi.org]

• Withdrawn

  […] drugs such as fenfluramine and phentermine in addition to dietary and behavioural modifications were reported to improve aminotransaminase levels in 11 obese patients, 39 but these drugs may induce cardiovascular and lung toxicity and they have been withdrawn [dx.doi.org]

This delay in diagnosis is illustrated in our case of a 53-year-old man who presented with hepatic hydrothorax and ascites, whose workup revealed cirrhosis due to NAFLD. [dx.doi.org]

Patients with high serum titers of autoantibodies and other features suggesting autoimmune liver disease (eg, very high aminotransferases or high globulin levels) should undergo a more thorough workup for autoimmune liver disease. [emedicine.com]

Thomas Jensen, Amanda Wieland, Melanie Cree-Green, Kristen Nadeau and Shelby Sullivan, Clinical workup of fatty liver for the primary care provider, Postgraduate Medicine, 10.1080/00325481.2019.1546532, (1-12), (2018). [doi.org]

This review discusses some of the major obstacles to drug development for NASH treatment. [ncbi.nlm.nih.gov]

Lifestyle modification is the foundation of treatment for patients with nonalcoholic steatosis. [jama.jamanetwork.com]

We identified 34 studies comprising 368,569 unique patients that characterized disparities in NAFLD prevalence, severity, or prognosis. [ncbi.nlm.nih.gov]

Expert commentary : This meta-analysis indicated that for NAFLD patients, obesity (according to ethnic-specific BMI cut-off points to define obesity) could predict a worse long-term prognosis. [doi.org]

Prognosis is often good unless complications (eg, variceal hemorrhage) develop. 1. [msdmanuals.com]

BACKGROUND: Iron overload disorders are hereditary hemochromatosis and secondary etiologies other than hereditary hemochromatosis. We describe 2 boys presenting with iron overload. [ncbi.nlm.nih.gov]

As a result, specialty societies, including the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver, have developed guidance on the epidemiology, diagnosis, and treatment of NAFLD and NASH [ncbi.nlm.nih.gov]

Pathophysiological mechanisms relating sarcopenia and NASH may include insulin resistance (IR) and increased inflammation. IR leads to accumulation of triglycerides in both muscle tissue and the liver. [ncbi.nlm.nih.gov]

This article will explore and evaluate our current understanding of NAFLD in childhood and adolescence and how it differs from adult NAFLD, in terms of its epidemiology, pathophysiology, natural history, diagnosis and clinical management. [doi.org]

Although the drugs being developed may prevent progression to cirrhosis or may decrease negative liver outcomes, their effects on cardiometabolic health and cancer prevention remain unknown. [ncbi.nlm.nih.gov]