Talk:Non-alcoholic fatty liver disease
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re protein kinase
- Fatigue, in particular, is quite marked. It is associated with daytime somnolonce but is not worse or better depending on the severity of the NAFLD on biopsy. doi:10.1136/gut.2007.139303 JFW | T@lk 21:24, 13 May 2008 (UTC)
Diagnosis and monitoring
Raja92 (talk · contribs) added some information presented at the AASLD annual meeting. Unfortunately, these papers have not yet been printed. I'm just posting a reminder here that we need to trace the studies on PubMed in the future.
Meta-analysis suggests that bariatric surgery improves NASH in 80%: R. Mummadi (University of Texas Medical Branch) - Mummadi R, et al "Effect of Bariatric Surgery on Nonalcoholic Fatty Liver Disease (NAFLD): A meta-analysis" AASLD Meeting 2007; Abstract 130 presented Nov. 5.
Super size me
PMID 18454505 was added. This is a study using the NHANES III dataset where it was demonstrated that unexplained mildly raised ALT was much less likely in people who drink one glass of wine a day. I have no access to the fulltext article, but I can see that this was an observational study that does not seem to have confirmed diagnosis of NAFLD in any way. This casts significant doubts on the choice of endpoint, and makes it a poor choice for a general purpose encyclpedia. JFW | T@lk 05:48, 30 May 2008 (UTC)
Last submission regarding the benefit ( or lack ) of antioxidants would need to be reworded in Light of Cochrane evaluation below
Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004996. Links Antioxidant supplements for non-alcoholic fatty liver disease and/or steatohepatitis.Lirussi F, Azzalini L, Orando S, Orlando R, Angelico F. University of Padova Medical School, Department of Medical and Surgical Sciences, Via Giustiniani, 2, Padova, Italy. email@example.com
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is characterised by fatty deposition in the hepatocytes of patients with minimal or no alcohol intake and without other known cause. NAFLD includes a wide spectrum of histologic abnormalities ranging from hepatic steatosis to non-alcoholic steatohepatitis (NASH), or even cirrhosis. Antioxidant supplements, therefore, could potentially protect cellular structures against oxidative stress and the resulting lipid peroxidation. OBJECTIVES: To systematically evaluate the beneficial and harmful effects of antioxidant supplements versus no intervention, placebo, or other interventions for patients with NAFLD or NASH. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register (June 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 2, 2006), MEDLINE (1966 to June 2006), EMBASE (1980 to June 2006), and the Chinese Biomedical Database (1978 to June 2006). No language restrictions were applied. SELECTION CRITERIA: Randomised clinical trials evaluating any antioxidant supplements versus no intervention, placebo, or other interventions in patients with NAFLD or NASH. Our inclusion criteria for NAFLD or NASH were based on history of minimal or no alcohol intake, imaging techniques showing hepatic steatosis, and/or histological evidence of hepatic damage (including simple steatosis, fatty infiltration plus nonspecific inflammation, steatohepatitis, fibrosis, and cirrhosis), and by exclusion of other causes of hepatic steatosis. DATA COLLECTION AND ANALYSIS: We extracted data from the identified trials and contacted authors. We used a random-effects model and fixed-effect model with the significant level set at P = 0.05. We evaluated the methodological quality of the randomised trials by looking at how the generation of allocation sequence, allocation concealment, blinding, and follow-up were performed. We made our analyses following the intention-to-treat method by imputing missing data. MAIN RESULTS: We identified six trials: two were regarded of high methodological quality and four of low methodological quality. None of the trials reported any deaths. Treatment with antioxidant supplements showed a significant, though not clinically relevant, amelioration of aspartate aminotransferase levels, but not of alanine aminotransferase levels, as compared to placebo or other interventions. Gamma-glutamyl-transpeptidase was decreased, albeit not significantly, in the treatment arm. Radiological and histological data were too limited to draw any definite conclusions on the effectiveness of these agents. Adverse events were non-specific and of no major clinical relevance. AUTHORS' CONCLUSIONS: There is insufficient data to either support or refute the use of antioxidant supplements for patients with NAFLD. It may be advisable to carry out large prospective randomised clinical trials on this topic.
NAFLD vs NASH
I think the nomenclature is confusing enough as is; the article isn't as clear as it could be in explaining the difference and prognostic implications. I'll try to find some time to work on this Wawot1 (talk) 01:43, 21 January 2010 (UTC)
- I thought NASH is the most severe form of NAFLD, and the subtype that may progress to fibrosis and cirrhosis. Sadly the terms are often used interchangeably in the workspace. JFW | T@lk 10:11, 21 February 2010 (UTC)