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)
Natural history25-37% of #NAFLD is #NASH. Fibrosis progression usually 1 stage every 7yrs. Fibrosis can be slow or rapid and there are many pathogenic drivers of NAFLD and it's progression #AACE2022 #endotwitter
NAFLD -- adipose overload leading to steatosis leading to inflammation leading to fibrosis and cirrhosis
Prevalence is high (US prevalence 38% for #NAFLD, 37% of which have NASH) and substantially underdiagnosed. DM2 + BMI >35 90% have steatosis!
Mortality is increased for the entire spectrum of NAFLD. Stage 2 Fibrosis Is the Tipping Point for
Liver Related Mortality
Identify the high risk groups (PreDM, DM, Obesity, increase CV factors, LAE elevation) and evaluate for #NAFLD. We need to increase screening #endotwitter #AACE2022
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