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The silent metabolic disease affecting millions worldwide

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Prof. Dr. Ali Canbay

Clinic Director, University Medical Center, Knappschaftskrankenhaus Bochum

Dr. Slavica Brnjic

Chief Executive Officer at VLVbio

Non-alcoholic fatty liver disease (NAFLD) is associated with risks of cancer, transplant and even death, yet few at risk of developing the disease are aware of the implications.

Understanding NAFLD

Non-alcoholic fatty liver disease (NAFLD), a condition where fat accumulates in the liver without the excess consumption of alcohol, has become the most common cause of liver disease in the Western world and is quickly rising to become the primary cause of liver transplants1. Due to the rise in obesity in the world, NAFLD is estimated to affect 24% of the global population, with high prevalence on all continents.

“This is related to the so-called Western lifestyle; fast food, lifestyle changes, and reduced physical activity,” says Professor Ali Canbay, a hepatologist in Germany.

NAFLD leads to inflammation in the liver, which gives rise to the phenotype, non-alcoholic steatohepatitis (NASH), a potentially fatal condition that affects 12% of the global adult population1.

Diagnosing NASH

The golden standard of diagnosing NASH patients is a liver biopsy, where a tissue sample is taken from the liver and assessed by a physician who determines the spread of fat, inflammation and fibrosis.

This process, however, gives rise to several limitations such as sampling and observer variability. More importantly, a biopsy comes with possible health risks for patients such as infection and bleeding.  

Due to the rise in obesity in the world, NAFLD is estimated to affect 24% of the global population, with high prevalence on all continents.

NHS, 2018

“A completely reliable diagnosis for NAFLD and advanced NASH can only be made by liver biopsy and histological evaluation. However, it is not possible to biopsy such a large number of potential at-risk patients, especially since a liver biopsy is also associated with ‘sampling errors’ and complications,” says Professor Canbay.

Due to the risks and high costs of biopsies, non-invasive biomarkers have become commonly used in clinics to identify patients with NASH. One option is to measure M30® to determine the amount of cell death in the liver, which can help in the identification and diagnosis of patients with NASH. “In our clinic, we use a diagnostic model that includes the measurement of M30® to find NASH patients and follow up in their treatment,” says Professor Canbay.

Dr Slavica Brnjic, Chief Executive Officer at VLVbio, explains: “One of the pressing needs in the field is to implement non-invasive and low-cost techniques for diagnosing and staging NASH. Our work at VLVbio is to spread information on the disease as well as increase the acceptance and adoption of non-invasive diagnostic techniques.

“Hopefully, in the near future, more at risk patients will be aware of the disease and patients will be more easily identified and treated accordingly.”

Sources: 1. Younossi Z, Koenig A, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease- Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84. | 2. Muthiah M, Sanyal A. Burden of Disease due to Nonalcoholic Fatty Liver Disease. Gastroenterology Clinics of North America. 2020;49(1):1-23.

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