Clinical Dilemmas in Non-Alcoholic Fatty Liver Disease by Williams, Roger -- Read -- Imperial Library of Trantor

Index

Cover Title Page Table of Contents List of contributors Preface PART I: Nature of the Condition

1 Non-alcoholic fatty liver disease

References

2 NAFLD

Introduction Prevalence of NAFLD worldwide Disease severity Obesity and metabolic syndrome Genetic predisposition NAFLD as a cofactor Conclusions References

3 Is insulin resistance the principal cause of NAFLD?

Introduction What is meant by insulin resistance? How is insulin resistance measured in vivo in man? Insulin resistance and NAFLD Conclusions References

4 Paediatric NAFLD

Introduction Developmental origins of paediatric NAFLD Paediatric NAFLD: Histological evidence of early progression Paediatric NAFLD: A distinct disease? Ductular reaction, hedgehog signalling and advanced fibrosis What do we know from other types of paediatric chronic liver disease? What are the known risk factors for progression of fibrosis in NAFLD? Conclusion References

5 Non-alcoholic fatty liver disease (NAFLD) as cause of cryptogenic cirrhosis

Introduction Cryptogenic cirrhosis: Definition and characteristics Pathological recognition of NAFLD/NASH in cryptogenic cirrhosis Evidence for NAFLD as the cause of cryptogenic cirrhosis Loss of steatosis in late NAFLD/NASH with cirrhosis Other possible causes of cryptogenic cirrhosis and future directions Summary References

6 Is NAFLD different in absence of metabolic syndrome?

Introduction Metabolically normal NAFLD, Hb, and iron Genetic factors and metabolically normal NAFLD Prognostic implications of metabolically normal NAFLD Does metabolically normal NAFLD require a specific treatment approach? Conclusions References

7 Occurrence of noncirrhotic HCC in NAFLD

The metabolic syndrome, NAFLD, and HCC Pathogenesis linking HCC and NAFLD Conclusions References

PART II: Factors in Disease Progression

8 Fibrosis progression

Introduction The concept of liver repair Mechanisms of liver fibrogenesis Key molecular pathways Conclusions and future Acknowledgements References

9 When is it NAFLD and when is it ALD?

Introduction Steatosis Inflammation Hepatocellular injury Fibrosis Other lesions Grading and staging: ALD and NAFLD References

10 Of men and microbes

Introduction Intestinal microbiome Conclusion References

11 Can genetic influence in non-alcoholic fatty liver disease be ignored?

Introduction What evidence suggests a heritable component to NAFLD? What genetic factors have been identified? Conclusions and clinical relevance References

12 Is there a mechanistic link between hepatic steatosis and cardiac rather than liver events?

Introduction Evidence supporting the association between NAFLD and CVD Mechanistic link between NAFLD and CVD Genetic association between fatty liver and cardiometabolic risk Conclusion References

PART III: Diagnosis and Scoring

13 How to best diagnose NAFLD/NASH?

Primary or secondary NAFLD? Histological diagnosis Noninvasive diagnostic procedures Recommendations for diagnosis in clinical practice References

14 The clinical utility of noninvasive blood tests and elastography

Introduction Use of noninvasive fibrosis tests in chronic liver diseases Noninvasive diagnosis of NASH Noninvasive fibrosis assessment Conclusions: Future directions References

15 Are the guidelines—AASLD, IASL, EASL, and BSG—of help in the management of patients with NAFLD?

A definition problem To screen or not to screen? The thin line between NAFL and NASH Therapy: An open and evolving question Special population: Pediatric patients Conclusions References

16 Imaging methods for screening of hepatic steatosis

Ultrasound Computed tomography Advantages and limitations of CT for screening Magnetic resonance imaging Qualitative estimation of hepatic fat on MRI Quantitative estimation of hepatic fat on MRI MRS References

17 Are the advantages of obtaining a liver biopsy outweighed by the disadvantages?

Introduction Diagnosis and assessment of disease severity Technical and logistical matters Conclusions References

18 Screening for NAFLD in high-risk populations

Introduction Nature of NAFLD: Relevance to screening Current opinion and guidelines The high-risk population Potential screening tests A practical approach to NAFLD screening Summary References

PART IV: Value of Treatment Measures

19 Defining the role of metabolic physician

Diagnosis and assessment of the obese patient Medical management of obesity Management of bariatric surgical patients Conclusions References

20 Should physicians be prescribing or patients self-medicating with orlistat, vitamin E, vitamin D, insulin sensitizers, pentoxifylline, or coffee?

Introduction Coffee consumption Orlistat Pentoxifylline Vitamin E Insulin sensitizers Vitamin D Conclusion References

21 Effects of treatment of NAFLD on the metabolic syndrome

Introduction Effect of insulin-sensitizing antidiabetic treatments on NAFLD and the MetS (Table 8.1) Conclusions References

22 What are the dangers as well as the true benefits of bariatric surgery?

Introduction Development of bariatric surgical procedures What are the risks of bariatric surgery? Benefits of bariatric surgery Conclusion References

23 Liver transplantation

Current results of liver transplantation for NASH Frequency of NAFLD recurrence and of metabolic syndrome after transplantation and clinical significance Impact of obesity on long-term outcome after liver transplantation for non-NASH indications Conclusion Acknowledgement References

PART V: What Does the Future Hold?

24 Molecular antagonists, leptin or other hormones in supplementing environmental factors?

Introduction Strategies to promote ‘healthier’ adipose tissue function Beyond diabetes and insulin signalling Lipid and dietary modification Hepatic oxidative stress Conclusion Acknowledgement References

25 What is the role of antifibrotic therapies in the current and future management of NAFLD?

Antifibrotic targets in NAFLD Challenges of clinical trial design in NAFLD What have we learnt from NAFLD antifibrotic trials to date? What are the most promising emerging antifibrotic therapies in NAFLD? Other emerging therapies Conclusions Acknowledgement References

26 Developmental programmingof non-alcoholic fatty liver disease

Human studies Animal models Cellular and subcellular mechanisms Nervous system Epigenetic mechanism Immune mechanism Gut microbiota Conclusions References

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