Lissa Bauer Profile picture
May 12 8 tweets 5 min read
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
Promising performance in using biomarkers to diagnose/screen for fibrosis. ELF with high sensitivity but low specificity to exclude fibrosis
Now on to imaging modalities -- Liver ultrasound Pros: High availability, low cost
• Cons: Not quantitative, low diagnostic accuracy for steatosis (20-30%)
VCTE -- Pros: easy to be trained and simple to use, large supporting literature, not time-consuming and
available at point-of-care
Cons: device is expensive (although testing affordable); less accurate in cases of mild fibrosis
MRE most accurate of imaging modalities to measure liver fibrosis but expensive and time consuming. LIver biopsy is still the gold standard but high cost
New AACE guideline algorithm for screening for advanced fibrosis related NAFLD

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More from @lissabauer

May 13
Excited to hear this talk about Time-Restricted Diets by Dr. Grajower moderated by @theweightmd I'll try to share what I learned #AACE2022 #endotwitter Image
What are time restricted diets? We are using intermittent fasting incorrectly -- most are actually doing time restricted eating Image
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Read 5 tweets
May 13
Let's hear The Evidence For and Against Combination #Thyroid Hormone therapy by Dr. Bianco #AACE2022 #Endotwitter. This conversation is controversial here are some of the main slides Image
Patient's on Lt4 reporting a lot of residual symptoms in energy, cognition ImageImage
Normal physiology the majority of thyroid hormone production is T4 (16:1 T4:T3) and gets converted peripherally to T3 (5mcg made in thyroid, 25mcg made peripherally) Image
Read 9 tweets
May 13
Now to talk about Phosphatonins and #phosphorus metabolism/bone disease by Dr. Kumar moderated by @sfeirjad...I'm ready to learn since admittedly I know little of this #AACE2022 #Endotwitter #bone Image
Why bother about phosphorus? Well it plays many roles in cellular signaling and maintenance of membrane structure of #bone. Low concentrations associated with rhabdo, decreased cardiac function and bone dysfunction (#osteomalacia, #rickets). low and high phos causes bone disease ImageImage
High Phos Concentrations are Associated with CV Disease and Excess Mortality in CRF and decreasing levels reduces CV mortality ImageImage
Read 12 tweets
May 13
Starting day 2 #AACE2022 with @ArchanaSadhu talking to us about #diabetes technologies in 2022 #endotwitter Image
Look how far we have come in #diabetes technology and there is still a lot more to go #AACE2022. #CGM technology has been a game changer and the accuracy continues to improve with each generation ImageImage
So what's new in the pipeline for #diabetes technology? Let me tell you starting with #dexcom G7. It will be smaller with a better MARD, better warm up and ALL-IN-ONE applicator and transmitter! Just pending FDA review #AACE2022 #endotwitter #medtwitter Image
Read 11 tweets
May 12
The third lecture of the series of NAFLD by Dr. Cusi - Fatty liver guru -- presenting on Current and future treatments
Pioglitazone decreases visceral fat (liver fat, CV fat, muscle fat) but increases SQ fat. Effective at decreasing NASH and fibrosis
Read 8 tweets
May 12
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

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