According to the
study, ’Nonalcoholic Fatty Liver Disease (Nafld) –
Pipeline Review, H2 2018’, NAFLD is one of the most common causes of
chronic liver disease and for most people, causes no signs and symptoms and no
complications. Among the most common symptoms that raise concern are malaise,
fatigue and diffuse abdominal discomfort especially in the upper right region.Nonalcoholic
fatty liver disease (NAFLD) is an umbrella term for a range of liver conditions
affecting people who drink little to no alcohol, typically less than fourteen
units in a week. NASH stands for nonalcoholic steatohepatitis and it is a
subtype of the disease.
As the name implies
the main characteristic of nonalcoholic fatty liver disease is too much
fat stored in liver cells. Some of the contributing factors that are considered
when studying the rise of the disease are alterations in dietary habits and the
increased prevalence of MetS components such as central obesity and type 2
diabetes. MetS refers to metabolic syndrome which is a cluster of risk factors.
Studies investigating the natural history of NAFLD validate its progression to
NASH often proceeding to advanced fibrosis and hepatocellular carcinoma. Recent
data also confirms that NAFLD and NASH correlate equally to obesity and type 2
diabetes globally. The disease burden of NAFLD mirrors the rapid recent rise in
the incidents of diabetes, obesity and the MetS. The real burden of NAFLD most
likely remains underestimated due to the long natural history of fibrosis
development in NAFLD and the lack of disease awareness in the physician as well
as patient communities. Further, since the ailment can coexist with other liver
diseases such as chronic hepatitis C, clear identification of NAFLD as the main
ailment may be difficult.
NAFLD is expected to become the next global epidemic soon however, despite its widespread
effects a lot is still unknown about it and its subtype NASH. At the same time
obesity, which was always considered a Western concept, is prevalent in Asia as
well and this gives NAFLD a penetrative opportunity into Asia. Its effects have
already begun to be witnessed as studies reveal that currently, the Asians
lying in BMI category ‘non-obese’ have been found to suffer from NAFLD. There
have been a number of observations made related to NAFLD and NASH found in
Western and Asian countries. The prevalence of NAFLD in both regions is nearly
same with one-fourth of the people affected however, the proportion of affected
patients that also had NASH is considerably greater in the Western countries as
compared to the Asian ones. Further studies also revealed that the proportion
of NAFLD patients with F3-4 fibrosis is small in Western nations and very low
in Asian nations, half the former’s proportion. The prevalence of NAFLD in
subjects with BMI less than 25 appears to be greater in Asian countries as
compared to the Western ones with the former’s likelihood being nearly double
that of the latter’s. Along with these, some other parameters were also
considered that present similar results in Western and Asian domains. One such
parameter is that of risk factors of NAFLD which are largely the same in both
contexts and consist of obesity, metabolic syndrome and genetics.
NAFLD is a globally
rising concern as it is now visibly affecting the far corners of the world.
Both NAFLD and NASH are strongly found to be related to obesity and metabolic
syndrome. As a result, lifestyle intervention cannot be denied. A comparative
analysis between two different regions of the world reveals interesting trends
with mainly the Western region being more strongly affected by NAFLD, NASH and
fibrosis however, the origins of the ailment that increase risk are similar to
the Asian region.
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