Pub Date : 2019-11-20DOI: 10.5772/intechopen.88041
E. Gad, Yasmin Kamel
Nonalcoholic fatty liver disease (NAFLD) is considered a major challenge because of its prevalence, difficulties in diagnosis, complex pathogenesis, and lack of approved therapies. It will become the main cause of chronic liver disease in adults and children and the leading indication for liver transplantation (LT) in the next decades replacing hepatitis C virus (HCV) infection [1]. It is characterized by excessive hepatic fat accumulation, associated with insulin resistance (IR), where liver pathology shows steatosis in >5% of hepatocytes or a proton density fat fraction >5.6% assessed by proton magnetic resonance spectroscopy (1HMRS) or quantitative fat/water selective magnetic resonance imaging (MRI) [2]. It represents a group of conditions ranging from simple asymptomatic liver steatosis (nonalcoholic fatty liver (NAFL)) (known by imaging or histology) to cirrhosis (nonalcoholic steatohepatitis (NASH) or cryptogenic), end stage liver disease (ESLD), and hepatocellular carcinoma (HCC), passing through nonalcoholic steatohepatitis (NASH), which is characterized by the presence of apoptosis, ballooning, inflammation, and fibrosis with the absence of secondary causes of hepatic fat accumulation such as significant alcohol consumption or viral infection [3]. In the majority of patients, NAFLD is commonly associated with metabolic comorbidities such as obesity, type 2 DM (T2DM), and dyslipidemia. So it became common after increased prevalence of these comorbidities [4]. Our book discusses some new topics related to NAFLD, where we divided it into four sectors: the first sector includes introductory chapter about NAFLD; the second sector contains experimental work related to the disease, while the third sector discusses diseases related to NAFLD; and finally the fourth sector includes a new noninvasive tool to diagnose NAFLD. The book gives hints regarding NAFLD prevalence, etiology, pathogenesis, pathology, diagnosis, and treatment. This introductory chapter discusses the recent updated data on the prevalence, natural history, pathophysiology, pathology, diagnosis, and treatment of the disease.
{"title":"Introductory Chapter: Nonalcoholic Fatty Liver Disease - What Should We Know?","authors":"E. Gad, Yasmin Kamel","doi":"10.5772/intechopen.88041","DOIUrl":"https://doi.org/10.5772/intechopen.88041","url":null,"abstract":"Nonalcoholic fatty liver disease (NAFLD) is considered a major challenge because of its prevalence, difficulties in diagnosis, complex pathogenesis, and lack of approved therapies. It will become the main cause of chronic liver disease in adults and children and the leading indication for liver transplantation (LT) in the next decades replacing hepatitis C virus (HCV) infection [1]. It is characterized by excessive hepatic fat accumulation, associated with insulin resistance (IR), where liver pathology shows steatosis in >5% of hepatocytes or a proton density fat fraction >5.6% assessed by proton magnetic resonance spectroscopy (1HMRS) or quantitative fat/water selective magnetic resonance imaging (MRI) [2]. It represents a group of conditions ranging from simple asymptomatic liver steatosis (nonalcoholic fatty liver (NAFL)) (known by imaging or histology) to cirrhosis (nonalcoholic steatohepatitis (NASH) or cryptogenic), end stage liver disease (ESLD), and hepatocellular carcinoma (HCC), passing through nonalcoholic steatohepatitis (NASH), which is characterized by the presence of apoptosis, ballooning, inflammation, and fibrosis with the absence of secondary causes of hepatic fat accumulation such as significant alcohol consumption or viral infection [3]. In the majority of patients, NAFLD is commonly associated with metabolic comorbidities such as obesity, type 2 DM (T2DM), and dyslipidemia. So it became common after increased prevalence of these comorbidities [4]. Our book discusses some new topics related to NAFLD, where we divided it into four sectors: the first sector includes introductory chapter about NAFLD; the second sector contains experimental work related to the disease, while the third sector discusses diseases related to NAFLD; and finally the fourth sector includes a new noninvasive tool to diagnose NAFLD. The book gives hints regarding NAFLD prevalence, etiology, pathogenesis, pathology, diagnosis, and treatment. This introductory chapter discusses the recent updated data on the prevalence, natural history, pathophysiology, pathology, diagnosis, and treatment of the disease.","PeriodicalId":162663,"journal":{"name":"Nonalcoholic Fatty Liver Disease - An Update","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132483071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-11DOI: 10.5772/intechopen.85780
Z. Sherif
Nonalcoholic fatty liver disease (NAFLD) affects a third of the world’s population and its rapid rise parallels the increase in hepatocellular carcinoma (HCC). NAFLD replacing hepatitis C virus (HCV) infection as a leading indicator for liver transplantation (LT) in the United States. NAFLD is a spectrum of disease ranging from simple steatosis (NAFL) to nonalcoholic steatohepatitis (NASH), which can progress to advanced fibrosis (AF) and cirrhosis, culminating in HCC. The main clinical concern of public health administrators is that many patients who are unaware of NAFLD remain undiagnosed and risk developing end-stage liver disease (ESLD). Clinicians overly rely on surrogate liver enzymes to identify patients with NAFLD, allowing for substantial liver disease to go unnoticed and untreated. Furthermore, according to epidemiological studies, in patients diagnosed with NAFLD, ethnicity plays a role in complications and treatment response, and ethnic correlations with NAFLD are thoroughly underreported. Although liver biopsy is the gold standard method for appropriately diagnosing and staging NAFLD, most patients can be effectively diagnosed non-invasively with imaging modalities and integrated tests that are routinely available in the clinic today. This chapter discusses the current global rise in the rates of NAFLD and HCC; the current key findings incidences and the recommended diagnostic approaches and in therapeutic methods. hyaline necrosis, hepatocyte ballooning, portal granulocytic inflammation, lobular
{"title":"The Rise in the Prevalence of Nonalcoholic Fatty Liver Disease and Hepatocellular Carcinoma","authors":"Z. Sherif","doi":"10.5772/intechopen.85780","DOIUrl":"https://doi.org/10.5772/intechopen.85780","url":null,"abstract":"Nonalcoholic fatty liver disease (NAFLD) affects a third of the world’s population and its rapid rise parallels the increase in hepatocellular carcinoma (HCC). NAFLD replacing hepatitis C virus (HCV) infection as a leading indicator for liver transplantation (LT) in the United States. NAFLD is a spectrum of disease ranging from simple steatosis (NAFL) to nonalcoholic steatohepatitis (NASH), which can progress to advanced fibrosis (AF) and cirrhosis, culminating in HCC. The main clinical concern of public health administrators is that many patients who are unaware of NAFLD remain undiagnosed and risk developing end-stage liver disease (ESLD). Clinicians overly rely on surrogate liver enzymes to identify patients with NAFLD, allowing for substantial liver disease to go unnoticed and untreated. Furthermore, according to epidemiological studies, in patients diagnosed with NAFLD, ethnicity plays a role in complications and treatment response, and ethnic correlations with NAFLD are thoroughly underreported. Although liver biopsy is the gold standard method for appropriately diagnosing and staging NAFLD, most patients can be effectively diagnosed non-invasively with imaging modalities and integrated tests that are routinely available in the clinic today. This chapter discusses the current global rise in the rates of NAFLD and HCC; the current key findings incidences and the recommended diagnostic approaches and in therapeutic methods. hyaline necrosis, hepatocyte ballooning, portal granulocytic inflammation, lobular","PeriodicalId":162663,"journal":{"name":"Nonalcoholic Fatty Liver Disease - An Update","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129334783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-31DOI: 10.5772/INTECHOPEN.82096
D. Feier, D. Muntean, N. Bastati, A. Ba-Ssalamah
The chapter will focus on the different aspects of nonalcoholic fatty liver disease (NAFLD). An update in noninvasive MR-based imaging will be offered in detail, pointing mainly to fat, iron, and fibrosis deposition and the accuracy of quantitative methods in disease grading and severity assessment. NAFLD is the most common cause of chronic liver disease (CLD) in Western countries. MRI is used to evaluate the disease, to assess the severity, and to quantify the amount of fat deposition, being also the method of choice to evaluate and quantify iron overload. Diagnosis and staging of liver fibrosis is one of the most challenging aspects of noninvasive imaging. “Virtual biopsy” refers to the possibility of imaging techniques to depict, map, and measure fibrosis minimizing the need for invasive liver biopsies in CLD. MRI allows an accurate determination of steatosis, iron overload, and fibrosis, even if they coexist.
{"title":"Current Noninvasive MR-Based Imaging Methods in Assessing NAFLD Patients","authors":"D. Feier, D. Muntean, N. Bastati, A. Ba-Ssalamah","doi":"10.5772/INTECHOPEN.82096","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.82096","url":null,"abstract":"The chapter will focus on the different aspects of nonalcoholic fatty liver disease (NAFLD). An update in noninvasive MR-based imaging will be offered in detail, pointing mainly to fat, iron, and fibrosis deposition and the accuracy of quantitative methods in disease grading and severity assessment. NAFLD is the most common cause of chronic liver disease (CLD) in Western countries. MRI is used to evaluate the disease, to assess the severity, and to quantify the amount of fat deposition, being also the method of choice to evaluate and quantify iron overload. Diagnosis and staging of liver fibrosis is one of the most challenging aspects of noninvasive imaging. “Virtual biopsy” refers to the possibility of imaging techniques to depict, map, and measure fibrosis minimizing the need for invasive liver biopsies in CLD. MRI allows an accurate determination of steatosis, iron overload, and fibrosis, even if they coexist.","PeriodicalId":162663,"journal":{"name":"Nonalcoholic Fatty Liver Disease - An Update","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128630775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.5772/INTECHOPEN.82200
Subha Mary Varghese, Jibu P. Thomas
Non-alcoholic fatty liver disease (NAFLD) is a condition where the content of intrahepatic triglycerides (steatosis) rises, inclusive or exclusive of inflammation and fibrosis (namely steatohepatitis). It is acknowledged all over the world as the leading cause of chronic liver disease (CLD). Mulberry, a phytonutrient-rich plant belongs to the genus Morus , has been widely used as one of the conventional medicinal plants due to its chemical composition and pharmacological utility. Identification of leaf extract ( M. latifolia ) revealed chlorogenic acid, rutin, quercetin, caffeic acid and coumaric acid as functional bioactive principles. Objective of the current study was to evaluate the beneficial effect of M. latifolia in treating HFCS-induced metabolic disorders, namely, dyslipidaemia and non-alcoholic fatty liver disease (NAFLD), in rat models. Study determined body weight, blood glucose, lipid profile, liver marker enzymes and histopathology of liver tissues. Study concluded that administration of M. latifolia leaf extract showed a significant decrease in body weight and the levels of lipid profile, blood glucose and liver marker enzymes in HFCS-induced rats compared to HFCS control rats. Histopathological studies confirmed the antihyperlipidaemic properties of M. latifolia leaf extract in reducing the hepatic fat accumulation causing regeneration of liver tissues in HFCS-fed rats.
{"title":"The Effect ofM. latifoliaLeaf Extract on High-Fructose Corn Syrup (HFCS)-Induced Non-alcoholic Fatty Liver Disease in Rat Models","authors":"Subha Mary Varghese, Jibu P. Thomas","doi":"10.5772/INTECHOPEN.82200","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.82200","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) is a condition where the content of intrahepatic triglycerides (steatosis) rises, inclusive or exclusive of inflammation and fibrosis (namely steatohepatitis). It is acknowledged all over the world as the leading cause of chronic liver disease (CLD). Mulberry, a phytonutrient-rich plant belongs to the genus Morus , has been widely used as one of the conventional medicinal plants due to its chemical composition and pharmacological utility. Identification of leaf extract ( M. latifolia ) revealed chlorogenic acid, rutin, quercetin, caffeic acid and coumaric acid as functional bioactive principles. Objective of the current study was to evaluate the beneficial effect of M. latifolia in treating HFCS-induced metabolic disorders, namely, dyslipidaemia and non-alcoholic fatty liver disease (NAFLD), in rat models. Study determined body weight, blood glucose, lipid profile, liver marker enzymes and histopathology of liver tissues. Study concluded that administration of M. latifolia leaf extract showed a significant decrease in body weight and the levels of lipid profile, blood glucose and liver marker enzymes in HFCS-induced rats compared to HFCS control rats. Histopathological studies confirmed the antihyperlipidaemic properties of M. latifolia leaf extract in reducing the hepatic fat accumulation causing regeneration of liver tissues in HFCS-fed rats.","PeriodicalId":162663,"journal":{"name":"Nonalcoholic Fatty Liver Disease - An Update","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127292648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.81474
Xinmu J. Zhang, Ruitang Deng
Bile acids are synthesized in the liver and tightly regulated through the enterohepatic circulation. Recent studies reveal that bile acids serve as hormone-like signaling molecules to activate nuclear receptors, notably farnesoid X receptor (FXR), regulating metabolic homeostasis of bile acids, cholesterol, lipids, and glucose. A connection between bile acids and nonalcoholic fatty liver disease (NAFLD) has long been recognized. Although inconsistent or even contradictory results are reported, a large body of evidence from clinical as well as preclinical studies demonstrates that bile acid homeostasis is disrupted in patients with NAFLD. The bile acid dysregulation gets worsening as NAFLD progresses from early stage simple steatosis to late stage nonalcoholic steatohepatitis (NASH) and NASH with fibrosis. As the risk factors for NAFLD, obesity and insulin resistance, which are often associated with NAFLD, contribute to the dysregulation of bile acids in patients with NAFLD. Total serum and fecal bile acid concentrations are mostly elevated in patients with NAFLD as a result of increased bile acid synthesis, elevated hepatic bile acids, and upregulation of bile acid transporters. The two negative feedback regulatory pathways for bile acid synthesis, FXR/SHP (small heterodimer partner) and fibroblast growth factor-19 (FGF19)/FGF receptor-4 (FGFR4), are impaired in patients with NAFLD.
{"title":"Dysregulation of Bile Acids in Patients with NAFLD","authors":"Xinmu J. Zhang, Ruitang Deng","doi":"10.5772/INTECHOPEN.81474","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.81474","url":null,"abstract":"Bile acids are synthesized in the liver and tightly regulated through the enterohepatic circulation. Recent studies reveal that bile acids serve as hormone-like signaling molecules to activate nuclear receptors, notably farnesoid X receptor (FXR), regulating metabolic homeostasis of bile acids, cholesterol, lipids, and glucose. A connection between bile acids and nonalcoholic fatty liver disease (NAFLD) has long been recognized. Although inconsistent or even contradictory results are reported, a large body of evidence from clinical as well as preclinical studies demonstrates that bile acid homeostasis is disrupted in patients with NAFLD. The bile acid dysregulation gets worsening as NAFLD progresses from early stage simple steatosis to late stage nonalcoholic steatohepatitis (NASH) and NASH with fibrosis. As the risk factors for NAFLD, obesity and insulin resistance, which are often associated with NAFLD, contribute to the dysregulation of bile acids in patients with NAFLD. Total serum and fecal bile acid concentrations are mostly elevated in patients with NAFLD as a result of increased bile acid synthesis, elevated hepatic bile acids, and upregulation of bile acid transporters. The two negative feedback regulatory pathways for bile acid synthesis, FXR/SHP (small heterodimer partner) and fibroblast growth factor-19 (FGF19)/FGF receptor-4 (FGFR4), are impaired in patients with NAFLD.","PeriodicalId":162663,"journal":{"name":"Nonalcoholic Fatty Liver Disease - An Update","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129520962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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