Patients with nonalcoholic fatty liver disease who also had high levels of alanine aminotransferase were more likely to also have worse adipose tissue insulin resistance and higher liver triglyceride content than NAFLD patients without high ALT levels, a recent study found. In patients with nonalcoholic steatosis and high ALT levels, liver triglyceride content was worse and steatosis on liver biopsy was higher than in patients with NASH and normal ALT levels.
Primary care physicians may focus on treating nonalcoholic fatty liver disease patients with high alanine transaminase levels, overlooking those at high risk for progressive hepatic damage, Baylor College of Medicine researchers reported in The American Journal of Gastroenterology. They said changes may be needed in NAFLD treatment in primary care settings.
Clinicians should screen for nonalcoholic steatohepatitis in patients with hypertension, type 2 diabetes, sleep apnea, a family history of NASH, a sedentary lifestyle, obesity or hyperlipidemia, according to guidelines from the World Gastroenterology Organisation. The group also cautions against treating all nonalcoholic fatty liver disease and NASH patients aggressively, and suggests first prescribing diet and exercise. Experimental therapies may be appropriate in patients who fail to achieve adequate weight loss, the group says.
Patients with nonalcoholic fatty liver disease may benefit from diet and exercise through improved medical conditions associated with the condition, according to a study from the University of Tsukuba in Japan. Patients on a diet and exercise plan saw improvements in hepatic steatosis, body weight, insulin resistance, and inflammation and oxidative stress measures, data showed.
People with non-alcoholic fatty liver disease were 69% more likely to die than the general population, according to study data from Sweden. Researchers said those with non-alcoholic steatohepatitis were 86% more likely to die.