Non-alcoholic fatty liver disease - a global public health perspective
Open accessAbstract
As the epidemics of obesity and type 2 diabetes mellitus increase worldwide, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing proportionately. The subtype of NAFLD which can be characterised as non-alcoholic steatohepatitis (NASH) is a potentially progressive liver disease that can lead to cirrhosis, hepatocellular carcinoma, liver transplantation, and death. NAFLD is also associated with extrahepatic manifestations such as chronic kidney disease, cardiovascular disease and sleep apnoea. NAFLD and NASH carry a large economic burden and create poor health-related quality of life. Despite this important burden, we are only beginning to understand its mechanisms of pathogenesis and the contribution of environmental and genetic factors to the risk of developing a progressive course of disease. Research is underway to identify appropriate non-invasive diagnostic methods and effective treatments. Although the risk of liver-related mortality is increased in patients with NAFLD and liver fibrosis stages F3 or F4, the leading cause of death is cardiovascular disease. Given the rapidly growing global burden of NAFLD and NASH, efforts must continue to find accurate non-invasive diagnostic and prognostic biomarkers, to develop effective treatments for individuals with advanced NASH and prevention methods for individuals at high risk of NAFLD and progressive liver disease.
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Fibrosis progression is mostly influenced by older age, post-menopausal state, Hispanic ethnicity, the presence and severity of cardiometabolic risk factors, as well as environmental and genetic factors.
“Fibrosis progression in turn is mostly in fl uenced by older age (though this may be more related to duration of exposure), post-menopausal state, Hispanic ethnicity, the presence and severity of cardiometabolic risk factors, as well as environmental and genetic factors. 34”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [34]
The Disease progression section identifies older age, visceral obesity, type 2 diabetes or insulin resistance, Hispanic ethnicity, and genetic and environmental factors as associated with progression; it also qualifies the age association by possible duration of exposure. The Mortality, HCC and liver transplantation section says metabolic syndrome can increase the rate of fibrosis progression. Neither section identifies post-menopausal state as a factor, so the full list is not supported. (LLM, conf=0.88)
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Flagged first, then by citations
Research works printed but not linked: 2
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- Authors
- Younossi, Z. M.
- Affiliations
- Inova Health System (US)
- Corresponding author
- Younossi, Zobair M.
- ORCID
- Younossi, Zobair M.
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 70
- Issue
- 3
- Pages
- 531-544
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W2899595328
- Cited by
- 2,149
- References
- 110
- Citations by year
- 2026: 138 · 2025: 255 · 2024: 345 · 2023: 332 · 2022: 388 · 2021: 353 · 2020: 243 · 2019: 94 · 2018: 1
- FWCI
- 24.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, obesity, type 2 diabetes, liver fibrosis, liver cirrhosis, hepatocellular carcinoma, cardiovascular disease, chronic kidney disease, sleep apnea, economic burden, health-related quality of life, pathogenesis, genetic and environmental risk factors, non-invasive diagnosis, prognostic factors, NASH treatment, prevention
- MeSH terms
- Forecasting, Humans, Public Health, Global Health, Causality, Non-alcoholic Fatty Liver Disease
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