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Up-to-date global epidemiology of nonalcoholic fatty liver disease

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 956-959页

作者： Richie Manikat Aijaz Ahmed donghee kim Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCAUSA

Nonalcoholic fatty liver disease(NAFLD)is known as the most prevalent cause of chronic liver disease globally,ranging from simple steatosis to nonalcoholic steatohepatitis(NASH),which can lead to advanced fibrosis and *** burden of NAFLD is projected to increase over the next decade because of the lack of effective approved medications and continued increases in obesity and *** with NAFLD are left with the challenge of‘lifestyle modification’,which is difficult to implement or maintain in a predictably effective fashion.

关键词： epidemiology NAFLD liver

Association of visceral obesity and early colorectal neoplasia

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World Journal of Gastroenterology 2013年第45期19卷 8349-8356页

作者： Eun Kyung Choe donghee kim Hwa Jung kim Kyu Joo Park Department of Surgery Healthcare Research Institute Seoul National University Hospital Healthcare System Gangnam Center Seoul 135-984 South Korea Department of Internal Medicine Healthcare Research Institute Seoul National University Hospital Healthcare System Gangnam Center Seoul 135-984 South Korea Department of Clinical Epidemiology and Biostatistics Asan Medical Center University of Ulsan College of Medicine Seoul 138-736 South Korea Department of Surgery Seoul National University College of Medicine Seoul 110-799 South Korea

AIM:To examine whether visceral adipose tissue(VAT)serves as a risk factor for colorectal adenoma-early colorectal cancer(CRC)***:A retrospective case-control study was conducted with 153 patients with stageⅠCRC,age/sex-matched 554 patients with colorectal adenoma and557 normal *** subjects underwent various laboratory tests,abdominal fat computed tomography(CT),and *** was defined as an intraabdominal adipose tissue area measured by CT *** tissue area was measured at the level of the umbilicus from CT *** used the lowest quartile of VAT and subcutaneous adipose tissue area as a reference ***:The body mass index(BMI),total cholesterol,fasting glucose and VAT areas were significantly different among normal,adenoma and CRC *** VAT area was 120.6±49.0 cm2in normal controls,130.6±58.4 cm2in adenoma group and 117.6±51.6cm2in CRC group(P=0.002).In univariate analysis,increased BMI was a risk factor for CRC compared to control(P=0.025).However,VAT area was not a risk factor for CRC compared to *** multivariate analysis that adjusted for smoking,alcohol consumption and subcutaneous adipose tissue area,VAT area was inversely related to CRC,compared to the adenoma(OR=0.53,95%CI:0.31-0.92,highest quartile vs lowest quartile).CONCLUSION:Our study shows that visceral obesity is not a risk factor for early *** obesity might influence the normal-adenoma sequence but not the adenoma-early carcinoma sequence.

关键词： Adipose tissue Visceral fat Obesity Colorectal cancer Colorectal adenoma Abdominal computed tomography

Body fat distribution:a crucial target for intervention in nonalcoholic fatty liver disease and fibrosis

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Hepatobiliary Surgery and Nutrition 2022年第5期11卷 738-742页

作者： Karn Wijarnpreecha Aijaz Ahmed donghee kim Division of Gastroenterology and Hepatology Department of MedicineUniversity of Arizona College of MedicinePhoenixAZUSA Division of Gastroenterology and Hepatology Department of Internal MedicineBanner University Medical CenterPhoenixAZUSA Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCAUSA

Over the past decades,obesity has become an epidemic *** impacts health burdens heterogeneously by the regional distribution of fat,not total body fat *** studies reported that regional body fat distribution could represent a significant risk factor for insulin resistance(1),type 2 diabetes mellitus,and cardiovascular disease(2).Nonalcoholic fatty liver disease(NAFLD)affects approximately a fourth of the population worldwide and has been linked with overweight/***,NAFLD can be seen in individuals without overweight/obesity,which is called lean *** has been shown that in terms of body fat distribution,visceral adipose tissue(VAT)has a stronger association with NAFLD and severity in NAFLD than subcutaneous adipose tissue(SAT)(3-6).

关键词： obesity NAFLD distribution

Economic burden and healthcare utilization in nonalcoholic fatty liver disease

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Hepatobiliary Surgery and Nutrition 2019年第2期8卷 181-183页

作者： Eric RYoo Aijaz Ahmed donghee kim Department of Internal Medicine Santa Clara Valley Medical CenterSan JoseCAUSA Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCAUSA

In the United States(US),the shift in the treatment paradigm following the introduction of second generation direct-acting antiviral(DAA)agents for hepatitis C virus(HCV)infection has favorably transformed the landscape of end-stage liver disease(ESLD)with a rapid decline in HCV-related liver transplantation;HCV had been the leading indication for liver transplantation for the last two decades(1).While the rate of liver transplantation in patients with HCV infection has plummeted in the US following the widespread application of DAA-based regimens in the pre-transplant setting,the rise in alcohol use disorder and obesity has catapulted alcoholic liver disease(ALD)to become the leading indication for liver transplantation in the US in 2016 followed closely by nonalcoholic steatohepatitis(NASH),a progressive subset of nonalcoholic liver disease(NAFLD)(1).Despite the decline in HCV-related liver transplantation in the US,the total number of liver transplants per year are on an upward trajectory as a result of marked increase in ESLD associated with ALD and NASH—an ominous trend.

关键词： nonalcoholic landscape spite

Road to identifying endpoint biomarkers in the treatment of nonalcoholic steatohepatitis: are we there yet?

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Hepatobiliary Surgery and Nutrition 2020年第2期9卷 244-246页

作者： donghee kim Luis Miguel Vazquez-Montesino Aijaz Ahmed Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCAUSA Department of Medicine Stanford University School of MedicineStanfordCAUSA

In the United States(US),the landscape of chronic liver disease has been in flux in recent years as chronic hepatitis C virus(HCV)infection is no longer the leading indication for liver transplantation and now ranks behind alcoholic liver disease(ALD)and nonalcoholic steatohepatitis(NASH)as the third leading indication for liver transplantation(1).The approval of second-generation direct-acting antiviral(DAA)agents in late 2013 heralded a revolutionary era in the treatment of HCV *** a recent population-based study,there was a marked increase in age-standardized mortality for HCV infection with annual percent change(APC)of 2.2%in the pre-DAA era[2007-2014],but a marked decline in age-standardized mortality rates for HCV in the DAA-era[2014-2017]with-6.5%of APC(2).While HCV-related mortality declined along with the introduction of DAA therapies,nonalcoholic fatty liver disease(NAFLD)-related death was on the rise at an accelerated pace in the US adults(3).Notably,age-standardized mortality for NASH-related cirrhosis increased significantly between 2007 and 2016(APC:15.4%;95%CI:14.1 to 16.7)(4).NAFLD-related advanced fibrosis remains a topic of interest because of its association with end-stage liver disease and hepatocellular *** the last 10 years from 2005 to 2016,NAFLD-related advanced fibrosis increased from 3%among subjects with NAFLD in 2005-2008 to 6%in 2013-2016 in the US adults(5).The prevalence of NAFLD-related advanced fibrosis is now estimated to be four million US adults(5).Longitudinal cohort studies looking into patients with NAFLD suggest that the fibrosis stage,and not the presence of NASH,predicted both the risk of overall and cause-specific mortality(6,7).

关键词： mortality treatment approval

Impact of sarcopenia on the progression of nonalcoholic fatty liver disease: a frequently forgotten association

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Hepatobiliary Surgery and Nutrition 2019年第3期8卷 260-261页

作者： Andrew A.Li Aijaz Ahmed donghee kim Department of Medicine Stanford University School of MedicineStanfordCAUSA Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCAUSA

The development of sarcopenia in patients with chronic liver disease has been recognized as a predictor of poor ***,or the progressive loss of skeletal muscle mass begins to manifest in the early stages of chronic liver disease and worsens with progression to advanced liver disease with a prevalence approaching 60%in patients with end-stage liver disease(1).

关键词： frequent skeletal approaching

New hope for hepatitis C virus:Summary of global epidemiologic changes and novel innovations over 20 years

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World Journal of Gastroenterology 2021年第29期27卷 4818-4830页

作者： Brittany B Dennis Leen Naji Yasmin Jajarmi Aijaz Ahmed donghee kim Department of Medicine McMaster UniversityHamilton L8S 4L8ONCanada Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCA 94304United States Department of Family Medicine McMaster UniversityHamilton L8P 1H6ONCanada Department of Health Research Methods Evidence and ImpactMcMaster UniversityHamilton L8S 4K1ONCanada

Hepatitis C virus(HCV)is a global health concern associated with significant morbidity and *** the approval of second-generation direct-acting antiviral agents(DAAs),interferon therapy and liver transplantation constituted the mainstay of *** introduction of well-tolerated oral DAAs in late 2013 has revolutionized HCV management with over 95%cure *** predominance of HCV-related liver transplantations has declined following the widespread approval of *** the unparallel efficacy observed among these novel therapies,pharmaceutical costs continue to limit equitable access to healthcare and likely contribute to the differential HCV infection rates observed *** reduce the burden of disease worldwide,essential agenda items for all countries must include the prioritization of integrated care models and access to DAAs *** transparent negotiations with the pharmaceutical industry,the consideration for compassionate release of medications to promote equitable division of care is *** we provide a literature review of HCV,changes in epidemiologic trends,access issues for current therapies,and global inequities in disease burden.

关键词： Hepatitis C virus Direct-acting antivirals Global health Liver transplantation People who inject drugs Liver cirrhosis

Clinical epidemiology and disease burden of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2017年第47期23卷 8263-8276页

作者： Brandon J Perumpail Muhammad Ali Khan Eric R Yoo George Cholankeril donghee kim Aijaz Ahmed Department of Medicine College of MedicineDrexel University Division of Gastroenterology and Hepatology Health Science CenterUniversity of Tennessee Department of Medicine Santa Clara Valley Medical Center Division of Gastroenterology and Hepatology Stanford University School of Medicine

Nonalcoholic fatty liver disease(NAFLD) is defined as the presence of hepatic fat accumulation after the exclusion of other causes of hepatic steatosis, including other causes of liver disease, excessive alcohol consumption, and other conditions that may lead to hepatic steatosis. NAFLD encompasses a broad clinical spectrum ranging from nonalcoholic fatty liver to nonalcoholic steatohepatitis(NASH), advanced fibrosis, cirrhosis, and finally hepatocellular carcinoma(HCC). NAFLD is the most common liver disease in the world and NASH may soon become the most common indication for liver transplantation. Ongoing persistence of obesity with increasing rate of diabetes will increase the prevalence of NAFLD, and as this population ages, many will develop cirrhosis and end-stage liver disease. There has been a general increase in the prevalence of NAFLD, with Asia leading the rise, yet the United States is following closely behind with a rising prevalence from 15% in 2005 to 25% within 5 years. NAFLD is commonly associated with metabolic comorbidities, including obesity, type Ⅱ diabetes, dyslipidemia, and metabolic syndrome. Our understanding of the pathophysiology of NAFLD is constantly evolving. Based on NAFLD subtypes, it has the potential to progress into advanced fibrosis, end-stage liver disease and HCC. The increasing prevalence of NAFLD with advanced fibrosis, is concerning because patients appear toexperience higher liver-related and non-liver-related mortality than the general population. The increased morbidity and mortality, healthcare costs and declining health related quality of life associated with NAFLD makes it a formidable disease, and one that requires more in-depth analysis.

关键词： Nonalcoholic fatty liver disease Hepatic steatosis Fatty liver Prevalence Incidence Fibrosis Risk factor Epidemiology Outcomes Nonalcoholic steatohepatitis

Nonalcoholic Fatty Liver Disease: Epidemiology, Liver Transplantation Trends and Outcomes, and Risk of Recurrent Disease in the Graft

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Journal of Clinical and Translational Hepatology 2018年第4期6卷 420-424页

作者： Andy Liu Artin Galoosian Dharmesh Kaswala Andrew A.Li Chiranjeevi Gadiparthi George Cholankeril donghee kim Aijaz Ahmed California Pacific Medical Center Department of MedicineSan FranciscoCAUSA California Pacific Medical Center Division of Gastroenterology and HepatologySan FranciscoCAUSA Stanford University School of Medicine Division of Gastroenterology and HepatologyStanfordCAUSA University of Tennessee Health Science Center Division of Gastroenterology and HepatologyMemphisTNUSA

In parallel with the rising prevalence of metabolic syndrome globally,nonalcoholic fatty liver(NAFL)disease is the most common chronic liver disease in Western countries and nonalcoholic steatohepatitis(NASH)has become increasingly associated with hepatocellular *** studies have identified NASH as the most rapidly growing indication for liver transplantation(LT).As a hepatic manifestation of the metabolic syndrome,NAFL disease can be histologically divided into NAFL and *** is considered a benign condition,with histological changes of hepatocyte steatosis but without evidence of hepatocellular injury or *** is distinct from NASH,which is characterized by hepatocyte ballooning and inflammation,and which can progress to fibrosis and cirrhosis,hepatocellular carcinoma,and liver *** for any other end-stage liver disease,LT is a curative option for NASH after the onset of decompensated cirrhosis or hepatocellular *** some studies have suggested increased rates of sepsis and cardiovascular complications in the immediate postoperative period,the long-term posttransplant survival of NASH cases is similar to other indications for *** of NAFL following LT is common and can be challenging,although recurrence rates of NASH are *** persistence or progression of metabolic syndrome components after LTare likely responsible for NASH recurrence in transplanted ***,while maintaining access to LT is important,concerted effort to address the modifiable risk factors and develop effective screening strategies to identify early stages of disease are paramount to effectively tackle this growing epidemic.

关键词： Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Liver transplantation Epidemiology Trends