Chronic hepatitis B and C together with alcoholic and non-alcoholic fatty liver diseases represent the major causes of progressive liver disease that can eventually evolve into cirrhosis and its end-stage complication...Chronic hepatitis B and C together with alcoholic and non-alcoholic fatty liver diseases represent the major causes of progressive liver disease that can eventually evolve into cirrhosis and its end-stage complications,including decompensation,bleeding and liver cancer.Formation and accumulation of fibrosis in the liver is the common pathway that leads to an evolutive liver disease.Precise definition of liver fibrosis stage is essential for management of the patient in clinical practice since the presence of bridging fibrosis represents a strong indication for antiviral therapy for chronic viral hepatitis,while cirrhosis requires a specif ic follow-up including screening for esophageal varices and hepatocellular carcinoma.Liver biopsy has always represented the standard of reference for assessment of hepatic fibrosis but it has some limitations being invasive,costly and prone to sampling errors.Recently,blood markers and instrumental methods have been proposed for the non-invasive assessment of liver fibrosis.However,there are still some doubts as to their implementation in clinical practice and a real consensus on how and when to use them is not still available.This is due to an unsatisfactory accuracy for some of them,and to an incomplete validation for others.Some studies suggest that performance of non-invasive methods for liver fibrosis assessment may increase when they are combined.Combination algorithms of non-invasive methods for assessing liver fibrosis may represent a rational and reliable approach to implement non-invasive assessment of liver fibrosis in clinical practice and to reduce rather than abolish liver biopsies.展开更多
Background and Aims:Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease and is closely related to metabolic syndrome and its risk factors.Worldwide,epidemiological studies have reported NA...Background and Aims:Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease and is closely related to metabolic syndrome and its risk factors.Worldwide,epidemiological studies have reported NAFLD prevalence rates of 5%to 30%depending on geographical variations.While epidemiological data suggest a progressively increasing prevalence of metabolic risk factors in Singapore,there are limited data about NAFLD per se in the community.We aim to explore the prevalence and perceptions of NAFLD in Singapore.Methods:Attendees at a gastroenterology public forum were enrolled in a cross-sectional observational study evaluating demographic,anthropometric and clinical information.The diagnosis of NAFLD was based on sonographic criteria.Metabolic syndrome was defined according to International Diabetes Federation guidelines.Perceptions of NAFLD were explored using a self-administered survey questionnaire.Results:A total of 227 subjects were recruited,with NAFLD being diagnosed in 40%of the cohort.Relative to those without NAFLD,subjects with NAFLD had higher male preponderance,older age,higher body mass index,waist circumference and more metabolic syndrome(all P<0.05).Although 71.2%subjects had heard about NAFLD before,only 25.4%of them felt that they were at risk of NAFLD.Comparable responses were observed in subjects with no metabolic risk factors relative to subjects with one or more metabolic risk factors(P>0.05).Of note,75.6%of subjects with one or more metabolic risk factors did not think that they were at risk of NAFLD.Conclusion:Our study suggests a significant local prevalence of NAFLD in the community including non-obese individuals.Considering the tendency to underestimate risk of NAFLD,enhanced public education about NAFLD is warranted to improve understanding.展开更多
基金Supported by An unrestricted grant from Roche-Italia
文摘Chronic hepatitis B and C together with alcoholic and non-alcoholic fatty liver diseases represent the major causes of progressive liver disease that can eventually evolve into cirrhosis and its end-stage complications,including decompensation,bleeding and liver cancer.Formation and accumulation of fibrosis in the liver is the common pathway that leads to an evolutive liver disease.Precise definition of liver fibrosis stage is essential for management of the patient in clinical practice since the presence of bridging fibrosis represents a strong indication for antiviral therapy for chronic viral hepatitis,while cirrhosis requires a specif ic follow-up including screening for esophageal varices and hepatocellular carcinoma.Liver biopsy has always represented the standard of reference for assessment of hepatic fibrosis but it has some limitations being invasive,costly and prone to sampling errors.Recently,blood markers and instrumental methods have been proposed for the non-invasive assessment of liver fibrosis.However,there are still some doubts as to their implementation in clinical practice and a real consensus on how and when to use them is not still available.This is due to an unsatisfactory accuracy for some of them,and to an incomplete validation for others.Some studies suggest that performance of non-invasive methods for liver fibrosis assessment may increase when they are combined.Combination algorithms of non-invasive methods for assessing liver fibrosis may represent a rational and reliable approach to implement non-invasive assessment of liver fibrosis in clinical practice and to reduce rather than abolish liver biopsies.
基金Medical staff:Ms Tan Quee Eng,Ms Wen Jiaohong,Ms Gladys Sham,Ms Lim Guat Sim,Ms Sukvinder Kaur,Dr Ho Ching Yun,Dr Aaron Chua and Dr Debra Han for assistance in the conduct of the study.Phillips Healthcare Singapore for loaning their Phillips ultrasound machines for the event.
文摘Background and Aims:Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease and is closely related to metabolic syndrome and its risk factors.Worldwide,epidemiological studies have reported NAFLD prevalence rates of 5%to 30%depending on geographical variations.While epidemiological data suggest a progressively increasing prevalence of metabolic risk factors in Singapore,there are limited data about NAFLD per se in the community.We aim to explore the prevalence and perceptions of NAFLD in Singapore.Methods:Attendees at a gastroenterology public forum were enrolled in a cross-sectional observational study evaluating demographic,anthropometric and clinical information.The diagnosis of NAFLD was based on sonographic criteria.Metabolic syndrome was defined according to International Diabetes Federation guidelines.Perceptions of NAFLD were explored using a self-administered survey questionnaire.Results:A total of 227 subjects were recruited,with NAFLD being diagnosed in 40%of the cohort.Relative to those without NAFLD,subjects with NAFLD had higher male preponderance,older age,higher body mass index,waist circumference and more metabolic syndrome(all P<0.05).Although 71.2%subjects had heard about NAFLD before,only 25.4%of them felt that they were at risk of NAFLD.Comparable responses were observed in subjects with no metabolic risk factors relative to subjects with one or more metabolic risk factors(P>0.05).Of note,75.6%of subjects with one or more metabolic risk factors did not think that they were at risk of NAFLD.Conclusion:Our study suggests a significant local prevalence of NAFLD in the community including non-obese individuals.Considering the tendency to underestimate risk of NAFLD,enhanced public education about NAFLD is warranted to improve understanding.
