Discover and read the best of Twitter Threads about #NAFLD

Most recents (20)

🔥NIT among #NAFLD in T2DM by @JeromeBoursier #ILC2022

n=1,051 biopsy-proven NAFLD
6 NITs - NFS, FIB4, VCTE, Fibrotest, Fibrometer & blood+VCTE
✅Performance⏬in T2DM

✅Approach:
- non-T2DM: FIB4 -> VCTE
- T2DM: VCTE / Fibrometer > Fibrometer

#LiverTwitter
🤔Impact on #NAFLD/NASH trials?
👍Enrich-approach in patient selection

#ILC2022 @EASLedu @EASLnews #LiverTwitter @IanARowe @DrLoomba @NASH_and_coffee
🔥MEFIB vs MAST vs FAST to detect #NAFLD >F2 by @DrLoomba at #ILC2022

✅n=563 biopsy-proven NAFLD
Sig fibrosis 51.2%, DM 50%
🎯AUROC using rule-in/out criteria

🏆MEFIB > MAST or FAST to identify F2 NAFLD

#LiverTwitter @EASLnews @EASLedu
Read 4 tweets
📢Personalized medicine in #NAFLD by @DrLoomba

✅Current gaps in #NAFLD:
- Rapid progressors
- non-cirrhotic HCC

😧At risk NASH (F2 beyond)? Try these👇
✅FAST (low PPV) - exclude biopsy
✅MAST (PPV 91-97) - rule-in & treat
✅MEFIB (AUROC 0.9)

#ILC2022 #Livertwitter @EASLedu
Personalized medicine in #NAFLD by @DrLoomba

🔥Gut microbiome (AUROC 0.936)
- Detect advanced #fibrosis
- Identify 1st-degree relative with #cirrhosis (ethnically universal)
👉DOI: 10.1016/j.cmet.2020.06.005

- FGF19 treatment response in #NASH

#ILC2022 #LiverTwitter @EASLedu
Personalized #NASH treatment by @DrLoomba

Choose yr drugs based on🎯
#Fibrosis reversal vs #NASH resolution?

✅Combination = way forward. Why?
⏫Efficacy
⏬Dose ( ?potentially ⏬AE)

#ILC2022 #LiverTwitter @jturnesv @aelsharkawy75 @IanARowe @DharJahnvi @drshafikuchay
Read 4 tweets
Diagnostic tools for diagnosis of #NAFLD and complications by Dr. Lomonaco #AACE2022 #endotwitter
#NAFLD has effects on other conditions including DM, CVD, CKD etc due to increased hyperinsulinemia, insulin resistance, proinflammatory factors etc
How do we screen for #NAFLD and find the ones with fibrosis? A lot will be missed if just checking transaminases. FIB-4 and NFS is a better screening tool
Read 8 tweets
Fantastic lecture by @scottisaacsmd on the Fatty liver epidemic and introduction to the new AACE Fatty Liver Guidelines released today. First lecture by @scottisaacsmd #AACE2022 #endotwitter
NAFLD is a spectrum that includes NASH. First rule out secondary causes.
Difference between NAFL and NASH? NAFL is just the accumulation of fat w/o ballooning or much inflamation. NASH has hepatocyte changes from ballooning and inflammation. IIt is staged also based on fibrosis (F0-F4)
Read 8 tweets
2 Outta 3 Ain't Bad

2 of the 3 biomarker miRNAs for Covid are also biomarkers for liver disease:

"Non-alcoholic fatty liver disease (NAFLD) is emerging as one of the most common chronic liver diseases worldwide...there has been increasing evidence for the involvement of>
microRNAs in the epigenetic regulation of genes
taking part in the development of steatosis and steatohepatitis, 2 main stages of NAFLD pathogenesis...miRNA profiles were studied in groups of patients with steatosis and steatohepatitis...>
According to the results of miRNA screening, 23 miRNAs were differentially expressed...MiR-195-5p and miR-16-5p are common differentially expressed miRNAs for both steatosis and steatohepatitis....New findings within the framework of this study are the dysregulation of>
Read 9 tweets
This one suggests that individuals with high serum microRNA-122 levels may be less responsive during diet/physical activity-induced weight loss, as far as hepatic fat content loss is concerned.
- In the current study of participants with abdominal obesity or dyslipidemia from an 18-month randomized, controlled diet and physical activity intervention trial, it was observed that serum miR-122 levels were positively associated with hepatic fat percentage at baseline.
- A greater elevation in miR-122 from baseline to 18 months was associated with a smaller reduction in hepatic fat content during the 18-month intervention process.
Read 5 tweets
A case!
⚠️11% of patients with incidentally discovered steatosis may be at risk for advanced hepatic fibrosis!
Read 16 tweets
It's Monday and time for us @GoggleDocs to #takeover the @cardiomet_CE account for the next few days.

It's time to revisit the recent #EASD2021 conference.

Highlights in what's new in
#T1D
#type2diabetes
#NAFLD
#CKD
#HeartFailure
Just to remind you guys

The @GoggleDocs are a bunch of 🇬🇧 docs/🤓 who are fascinated about the cardio-metabolic conditions we are increasingly managing.

Please check out our @YouTube channel
youtube.com/channel/UC8Tzu…
This accredited educational program is intended for healthcare providers only, and is supported by grants from AstraZeneca, Bayer, Chiesi, and NovoNordisk. Follow this thread for a link to credit. CE/#CME credit for #physicians, #nurses, #pharmacists in US, Canada, GB, EU.
Read 22 tweets
Ferritin may be associated with glucose metabolism disorders and metabolic syndrome even in people without hepatic steatosis or hepatic iron overload.
Hepatic steatosis and hepatic iron overload modify the association of iron markers with glucose metabolism disorders and metabolic syndrome (open access)

doi.org/10.1111/liv.14…

#MetabolicSyndrome #NAFLD #diabetes #InsulinResistance #nutrition #diet
- "serum ferritin concentrations were associated with higher prevalence of IGM, T2DM and MetS as well as higher levels of fasting glucose, 2-h glucose, 2-h insulin, HOMA-IR and HbA1c in the total population independent of inflammatory markers and hepatic enzymes...
Read 6 tweets
In this one, daily consumed beverages consisted of either pure fructose or sucrose for 7 weeks increased basal hepatic fatty acid synthesis comparably with the LDL particle distribution shifting towards smaller, more atherogenic particles. Image
Fructose- and sucrose- but not glucose-sweetened beverages promote hepatic de novo lipogenesis: A randomized controlled trial (open access)

doi.org/10.1016/j.jhep…

#nutrition #diet #NAFLD
But wait, there's more!

a) There was a pure glucose group as well. An increased hepatic FA synthesis was not observed in this group.
b) Unexpectedly, fructose and sucrose increased basal hepatic FA synthesis comparably. Image
Read 5 tweets
MAFLD vs NAFLD: Let the contest begin! onlinelibrary.wiley.com/doi/full/10.11…
Although there are concerns about the name change, it is not going to go away. We all need to become familiar with the debate. Also worth reading the excellent paper in reference 4. #livertwitter #MAFLD #NAFLD Image
What’s in a name? Please read this excellent piece. (I am one of the authors in this @LiverInt paper #MAFLD #NAFLD #Livertwitter
onlinelibrary.wiley.com/doi/10.1111/li…
Read 3 tweets
1/3
The devil is in the 'detailed' #drug history #clinical
22 yr male, underweight
Teetotaler
Fatigue, appetite loss
Liver test AST 400 ALT 600
Viruses negative
Liver #biopsy 👇Severe #fatty #liver #disease, Mallory Denk++
#livertwitter #pathology #MedTwitter #MedStudentTwitter Image
2/3
The culprit 👇#Ayurveda #medicine
#Ayurvedic jam with butter, honey, milk as base given for premarital #weight gain! 3 months after stopping, liver tests normal
Consider #drug induced fatty liver in #patients. Not everyone is #metabolic #syndrome
#pseudoscience #Nash #nafld Image
3/3
Common drugs causing fatty liver
Steroids, Valproate
Inj Tetracycline
#HIV #AIDS meds NRTIs
Rare - methotrexate, chemodrugs irinotecan, 5FU, tamoxifen
Also important is Amiodarone
Herbals with #Margosa oil too
Remember #alternative meds rich in fats are important causes too.
Read 3 tweets
#Ayurvedic treatment of fatty #liver – real world evidence: A #Thread
1/n
Overweight woman, early 40’s. Routine liver tests, mild enzyme abnormalities. Advised #ultrasound liver, showed grade 2 #fattyliver. GP advised vitaminE and #weightloss, review in 3mo
#livertwitter
2/n
Patient and husband doubtful. Hears fatty liver disease can lead to #cirrhosis. Seeks advice from #Ayurvedic practitioner nearby #home since #Herbal #DRUGS = safe. Assures complete #cure through #Ayurveda. Prescribes multiple #medicines, advises almost all foods restriction.
3/n
Lets look at medicines. #tablet APFIL. Packet mentions ‘for liver #diseases’. Which liver disease? There is #alcohol related, #hepatitis B/C, #NAFLD, primary biliary #cholangitis and more causes. Nine #herbs extract combo - clinical #evidence on safety and benefit ❌
Read 14 tweets
PLease welcome my favourite gastroenterologist Dr Lay Gan to the twitter world @theng_gan is my friend, colleague, an expert endoscopist, hepatologist and IBD specialist. An outstanding researcher with a PhD in #fattyliver
#IBD #livertwitter #NASH #NAFLD #MondaynightIBD
Read 3 tweets
1/8 My latest teaspoon of sugar infogram is here! nice.org.uk/guidance/ng28/… … These represent the glycaemic load of portions of various foods to help you predict the glycaemic consequences of dietary choices. Based on this paper insulinresistance.org/index.php/jir/… The others will follow
2/8. I wanted to show that glucose can come from three sources: Naturally sugary foods. Foods with added sugar. Starchy foods that digest down into surprisingly large ammounts of glucose The glycaemic load of each food is re-worked out in terms of 4g. teaspoons of table sugar
3/8 This is the first infogram. Diet makes such a difference to #T2D This has been downloaded hundreds of thousands of times. All have been translated into five languages so far. Find them and the translations here: phcuk.org/sugar/ There is no copyright so share at will.
Read 8 tweets
Today I would like to read and tweet about non-#covid things

Will start a string of pearls and 🔥🌶takes from recent papers #livertwitter #gitwitter #cirrhosis
This paper in #amjgastro compared refeeding @ 24 v48 hrs after endoscopic interventions for peptic ulcers. 24 hours was “not noninferior”. multiple limits
1️⃣ ⬆️mortality in 48h
2️⃣diff duration of iv ppi
My 🌶🌶 take: feed your patients when they want! ImageImageImageImage
This @LiverInt multinational study shows that noninvasive tests help sort high from low risk for liver-related events and, to a degree, ❤️events in #nafld

🌶take: this is how we need to do #nafld epi from now on ImageImage
Read 7 tweets
@AGA_Gastro highlights #NASH #NAFLD first up @VidalPuig Where do the fatty acids go? sciencedirect.com/science/articl…
#NAFLD #NASH How much does the clock matter for pathophysiology or therapeutics #circadian sciencedirect.com/science/articl…
“Lost in Translation” or Utility at Last? NASH biomarkers #genetics and risk prediction beyond PNPLA3 sciencedirect.com/science/articl…
Read 6 tweets
1/4: GRAPH OF THE WEEK! Abnormal liver function, fatty liver #NAFLD #NASH now affects 20% of the developed world BUT WHY? For years I thought it was drugs or alcohol, so did the Three gastroenterologists who saw this lady between 1996 and 2009 Look rapid improvement on low carb
2/4 Who knew but we make liver fat not from dietary fats but sugar and starchy carbs Its called De novo lipogenesis. Guess what insulin and glucose is involved, look doi.org/10.1172/JCI134… The liver fat produced is called triglyceride and is more important than I used to think
3/4 So its like insulin pushes blood glucose into liver cells which turn it into triglyceride. Over time the liver fills with this fat hence #fattyliver #NAFLD also inflammation may set in #NASH My free @rcgp podcast is here only 18 mins @MartinRCGP elearning.rcgp.org.uk/mod/page/view.…
Read 4 tweets
ALERT: Based on popular demand, #NAFLD #tweetorial for primary care starts here. I guess it's a risk of calling yourself the "hepatoMD".

Topics: What is #NAFLD? How to diagnose it? Who to worry about? Who to refer? How to monitor?

#medtwitter #FOAMed
#NAFLD is an umbrella term. On one end of the spectrum there is 'simple steatosis', and on the other end there is 'NASH'. NASH is the clinical entity liver folks worry about because it causes liver disease.
So what causes NAFLD?
Best way to think of it is as a metabolic disease caused by insulin resistance, that is caused by genetic/environmental/lifestyle factors leading to adiposity.
Read 22 tweets

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