[Overview of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis Management]

Relationships of Dietary Habits and Physical Activity Status with Non-Alcoholic Fatty Liver Disease Featuring Advanced Fibrosis

(1) Aim: Hepatic fibrosis is a prognostic factor for disease progression in non-alcoholic fatty liver disease (NAFLD). We aimed to determine the relationships between diet, physical activity, and the progression of liver fibrosis. (2) Methods: The 349 participants were categorized by their FibroScan-aspartate aminotransferase score, and they completed a questionnaire regarding their diet and physical activity. (3) Results: There were 233 patients in the negative-on-screening group, 78 in the gray zone group, and 38 in the positive-on-screening group. The frequencies of consumption of soybeans and soybean products and of light-colored vegetables were lower in the positive group; whereas the frequencies of consumption of snack food and fried sweets, jelly and pudding, fried food, and butter, lard, and beef tallow were higher. The odds ratios for the fibrosis progression in patients who consumed fried food ≥4 times/week was 2.21. The positive group also showed lower physical activity level (PAL) and exercise (Ex, metabolic equivalents for tasks (METs)/hour/week). The patients who undertook Ex at >7.5 had an odds ratio of 0.21 for the fibrosis progression. (4) Conclusion: High consumption of fried food and low Ex are risk factors for the fibrosis progression in NAFLD.

Ultrasound-based techniques for noninvasive diagnosis of liver steatosis in nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) has become a worldwide medical and social problem. Although nonalcoholic steatosis can be reversed, some patients still progress to nonalcoholic steatohepatitis, liver cirrhosis, and even liver cancer. Therefore, early diagnosis and accurate disease assessment of NAFLD have become an important basis for its intervention treatment and prognosis improvement. Although liver biopsy is the gold standard for the diagnosis of NAFLD, it is not an ideal reference standard, and MRI-PDFF is more often used in clinical research. The non-invasive examination based on ultrasound detection has also become a hot spot of NAFLD research. This paper discusses the ultrasonic diagnosis technology for liver steatosis in NAFLD, with an aim to provide a safe and practical basis for the diagnosis, disease evaluation, and treatment intervention of NAFLD.

Nutritional status and energy metabolism in elderly patients with nonalcoholic fatty liver disease

BACKGROUND

With the aging of global population and the increase in the incidence of NAFLD, the research of elderly NAFLD population is particularly important.

AIM

To study the nutritional status and energy metabolism in elderly patients with nonalcoholic fatty liver disease (NAFLD) to provide evidence for disease evaluation, clinical monitoring, and treatment intervention.

METHODS

One hundred and eighteen elderly patients (≥ 60 years) with NAFLD were enrolled at Department of Gastroenterology Tianjin Third Central Hospital from January 2017 to January 2019. A non-NAFLD group consisting of non-NAFLD volunteers ≥ 60 years was also included. Nutritional status and energy metabolism were evaluated with a body composition analyzer and metabolic cart ( anthropometric measurement, clinical biochemical examination, etc.).

RESULTS

Body composition analysis showed that the waist-to-hip fat ratio and body fat content of the NAFLD group were significantly higher (waist-to-hip fat ratio 0.95 vs 0.92, body fat 27.20 vs 19.60 kg, P < 0.05) compared with those of the non-NAFLD group. The results of metabolic vehicle showed that the resting energy expenditure (REE) of the NAFLD group was increased (1769.00 vs 1706.00 vs 1323.00). In elderly NAFLD patients, body fat, waist-to-hip fat ratio, basal metabolism, and REE in the mild fatty liver group were significantly lower than those in the moderate-severe fatty liver group.

CONCLUSION

In elderly patients with NAFLD, there are nutritional imbalance and energy metabolism disorder. The nutritional status and energy metabolism of elderly NAFLD patients can be comprehensively evaluated and monitored with a body composition analyzer and metabolic vehicle, so as to provide evidence for disease intervention.