CLD Special Issue: Non-alcoholic Fatty Liver Disease

Clinical Liver Disease -Digital Liver Disease Journal

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This issue - September 25 2012

Special Issue: Non-alcoholic Fatty Liver Disease
September 2012

Volume 1, Issue 4

Pages 98–132

 

Nonalcoholic fatty liver disease: Definitions, risk factors, and workup (pages 98–102)

Puneet Puri and Arun J. Sanyal
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.81

In this introduction to CLD's special issue on NAFLD, Drs. Puri and Sanyal define nonalcoholic fatty liver disease (NAFLD) and its progressive form, non-alcoholic steatohepatitis (NASH), addressing histology, risk factors, and work up.
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Nonalcoholic fatty liver disease: Indications for liver biopsy and noninvasive biomarkers (pages 103–106)
Mazen Noureddin and Rohit Loomba
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.65

Liver biopsy is the gold standard to confirm NASH, a progressive form of NAFLD. Biomarkers and clinical prediction rules for refining the management paradigm of NAFLD are emerging.
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Histological assessment of nonalcoholic fatty liver disease in adults and children (pages 107–110)
Elizabeth M. Brunt
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.31

From the initial studies that solidified the clinicopathological characteristics of NASH into the lexicon of hepatology to the current time, refinements of the histological features in adults and children have been proposed and studied. In this review, Dr. Brunt highlights our current knowledge.
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Natural history of nonalcoholic fatty liver disease (pages 111–112)
Rohini Mehta and Zobair M. Younossi
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.27

NAFLD and NASH are common causes of chronic liver disease worldwide. Closely associated with the epidemic of obesity NAFLD ranges from non-alcoholic fatty liver (simple steatosis or NAFL) to NASH, which could potentially progress to fibrosis and cirrhosis and predispose patients to adverse liver- and cardiovascular-related outcomes. Drs. Mehta and Younossi review the natural history of NAFLD.
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Assessment and management of comorbidities (including cardiovascular disease) in patients with nonalcoholic fatty liver disease (pages 113–115)
Kathleen E. Corey and Raj Vuppalanchi
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.26

NAFLD is associated with an increased risk of cardiovascular disease (CVD) and is frequently associated with metabolic syndrome. This creates a pressing need for the diagnosis and management of the comorbidities of NAFLD, including CVD. Drs. Corey and Vuppalanci guide clinicians in the assessment and management of metabolic disease and CVD in patients with NAFLD.
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Treatment of nonalcoholic fatty liver disease: Role of dietary modification and exercise (pages 116–117)
Angelo H. Paredes, Dawn M. Torres and Stephen A. Harrison
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.63

The treatment of NAFLD is a patient-centered process that requires a patient to accept responsibility for lifestyle modifications. Evidence is emerging that allows physicians to guide patients better with diet and exercise counseling. Drs. Paredes, Torres, and Harrison explain.
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Management of nonalcoholic fatty liver disease: Role of bariatric surgery (pages 118–120)Julia Wattacheril and Naga Chalasani

Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.80

On the basis of the available data regarding the safety of patients with NAFLD who have indications other than liver disease for weight-loss surgery, bariatric surgery is not contraindicated. However, the risks associated with bariatric surgery are not insignificant: death, reintervention, venous thromboembolism, and the failure to be discharged from the hospital.
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Management of nonalcoholic steatohepatitis: Pharmacotherapy (pages 121–123)
Vlad Ratziu
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.74

Current guidelines do not recommend the use of hepatic pharmacological therapy in patients with steatosis alone. Instead, patients with NASH and significant liver disease (bridging fibrosis) are good candidates for therapy. Dr. Ratzui outlines the current guidelines, best available evidence, and potential pharmacologic management of the patient with NASH.
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Pediatric nonalcoholic fatty liver disease: Prevalence, diagnosis, risk factors, and management (pages 124–127)
Stavra A. Xanthakos and Rohit Kohli
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.75

In their interview with CLD Editorial Board member John C. Bucuvalas, MD, Drs. Xanthakos and Kohli discuss the challenges in managing the pediatric patient with NAFLD, a growing patient population in both developed and developing countries. NAFLD in youth is often clinically silent and is discovered only upon screening or the incidental testing of serum aminotransferase levels.
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Management of nonalcoholic fatty liver disease in children (pages 128–129)Jean P. Molleston
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.66

In the context of limited data and controversial approaches to screening, management of pediatric NAFLD presents many challenges for healthcare providers. Dr. Molleston outlines the reviews the best available evidence, recommends management approaches, identifies limitations in the current evidence base, and highlights other important aspects in the care of children with chronic liver disease, such as immunization against hepatitis A and B and counseling to avoid potential hepatotoxins such as alcohol.
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Liver transplantation and nonalcoholic fatty liver disease (pages 130–132)
Kymberly D. Watt
Article first published online: 25 SEP 2012 | DOI: 10.1002/cld.67

NASH-related cirrhosis is the third most common indication for transplantation in the current era and accounts for 10% to 13% of transplants performed. The need for liver transplantation in patients with NAFLD is growing. Dr. Watt explains the impact of disease recurrence on short- and medium-term survival and addresses management approaches necessary to improve long-term survival.
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Source - Non-alcoholic Fatty Liver Disease