Non-Alcoholic Fatty Liver Disease is On the Rise
This past November, Drs. Dickstein and Oviedo attended The Liver Meeting® 2018. This premier conference took place in San Francisco, where over 9,500 hepatologists and hepatology health professionals from across the nation and around the world gathered to exchange the latest liver disease research, discuss treatment options and interact with colleagues. The meeting provided patient care and ongoing research that we would like to share with you, our patients.
Non-Alcoholic fatty liver disease (NAFLD) is a condition in which fat accumulates in the liver in people who drink little or no alcohol. It is very common, with over 3 million cases per year in the U.S. Diagnosis requires a lab tests and imaging. While there is no known cure, treatments are available. NAFLD can last several years or be lifelong.
Does Fatty Liver Run in Families?
Can you Inherit a Fatty Liver?
Studies have shown that Non-Alcoholic Fatty Liver Disease has a shared genetic risk factor for the metabolic syndrome, which is a group of medical conditions that can lead to conditions such as heart disease and diabetes. To address whether NAFLD can be inherited, researchers in Southern California conducted a study analyzing a group of 156 people. The group was made up of 37 identical twins, 13 fraternal twins and 28 sets of sibling/sibling and parents/offspring pairs. Researchers used advanced MRI techniques to assess each participant for fat and fibrosis content in the liver and studied their blood tests for special markers of the disease called serum metabolites. The results of the study showed over 50 serum metabolites or genetic factors were associated with NAFLD when the researchers adjusted their findings to consider age, sex, and Hispanic ethnicity. The researchers also found that a link between genetics and gut microbiome in the development of NAFLD. By finding better markers and adjusting the gut microbiome, scientists hope to improve the diagnosis and treatment of NAFLD.
Liver Cancer’s Relationship with Aspirin and Dietary Supplements
Can an Aspirin a Day Keep Liver Cancer Away?
Hepatitis B is a viral infection that attacks the liver. HBV can be contracted through contact with an infected person’s blood or other bodily fluid. The infection can either be acute or chronic. Roughly 240 million people worldwide have chronic HBV, and the highest prevalence of the virus is located in Asia and Africa. Past research has suggested that daily aspirin therapy, which is often prescribed to prevent cardiovascular disease, may also prevent the development of cancer. However, clinical evidence was lacking for the effectiveness of aspirin therapy in preventing HBV-related liver cancer. Liver cancer is the second leading cause of cancer death worldwide, and HBV is the most prevalent risk factor in Asia.
Researchers in Taiwan conducted a nationwide study to determine if aspirin therapy could reduce liver cancer risk. The incidence of liver cancer in the group treated with aspirin therapy was significantly lower than that in the untreated group in five years. The researchers found that aspirin therapy was independently associated with reduced liver cancer risk in hepatitis B.
Five Years of Regular Aspirin Use Helps Prevent Common Liver Cancer
What is true for hepatitis B is also true in other liver patients. Data from a new study conducted at the Massachusetts General Hospital and presented at The Liver Meeting found that taking aspirin is associated with a dose-dependent reduction in the risk of hepatocellular (liver) cancer or HCC. The study showed that the reduction in this cancer risk is apparent after at least five years of regular aspirin use. Though evidence suggests aspirin may prevent HCC, it remains unclear the exact dosage and duration needed to prevent it.
Regular aspirin use (two or more standard aspirin tablets- 325 mg- per week) was associated with significantly lower HCC risk compared to non-regular aspirin use.
The Frequency of Herbal and Dietary Supplement Mislabeling
The herbal and dietary supplements industry is a multi-billion-dollar-per-year enterprise in the U.S. Over 20 percent of cases of liver injury reported to the U.S. Drug-Induced Liver Injury Network (DILIN) are attributed to herbal and dietary supplements. According to research presented at The Liver Meeting, herbal and dietary supplement mislabeling is common and is often a cause for liver damage. Mislabeling was defined by researchers when the chemical analysis of herbal and dietary supplements did not conform with the ingredients listed on the label.
Due to the fact that the herbal and dietary supplements are not required by the FDA to be tested for safety or effectiveness, there is growing concern that potentially mislabeled products could contain ingredients that could be highly toxic and damaging to the liver. To assess this concern, researchers conducted a chemical analysis of 341 herbal and dietary supplement products from 1,268 patients enrolled in DILIN. Only 90 of 203 products contained labels that accurately reflected their contents. Mislabeling occurred in 80 percent of products used for bodybuilding and performance enhancement, and 72 percent of products used for weight loss. It appears that the adage “Beware what you eat” also applies to dietary supplements and herbal remedies.
Alcohol Abuse
The Increasing Cost of Alcohol Abuse
Alcoholic cirrhosis is scarring of the liver due to heavy alcohol. It is a major cause of liver disease and death in the U.S. and worldwide. According to research presented at The Liver Meeting, health care costs patients with alcoholic cirrhosis are nearly twice that of non-alcoholic cirrhosis patients in the U.S. Alcohol use disorder is on the rise and rising rates of alcohol-use disorders are predicted to lead to further increases
Researchers in Michigan calculated yearly prevalence trends for alcoholic and non-alcoholic cirrhosis and using this data they found that patients with alcoholic cirrhosis were significantly more likely to be diagnosed long after liver deterioration had already begun and more likely to be admitted and readmitted within a 30-day period. Health care costs were found to be nearly double for patients in the first year after diagnosis compared to patients without alcoholic cirrhosis. Direct health care costs for alcoholic cirrhosis totaled around $5 billion! If you are a male taking more than 4 drinks a day or a woman taking more than 2 drinks a day, you may be at risk for alcoholic liver disease.