Clinical Nutrition

Biography

Biography: Royce P Vincent

Abstract

Obesity epidemic has led to a rapid rise in related co-morbidities. Thus, Non-Alcoholic Fatty Liver Disease (NAFLD) has become increasingly common worldwide over the last decades. NAFLD is characterized by liver steatosis (accumulation of triglycerides >5% in liver weight). By definition NAFLD requires that (i) there is evidence of hepatic steatosis, either by imaging/histology (ii) there are no causes for secondary hepatic fat accumulation - significant alcohol consumption, steatogenic medication, hereditary disorders etc. NAFLD usually develops in the context of the metabolic syndrome and is strongly associated with insulin resistance, obesity and dyslipidemia. It is estimated that in Europe nearly 25% of adults with fatty liver have NAFLD. The disease reaches a peak in the 5th and 6th decades of life. NAFLD comprises a disease spectrum spanning from non-inflammatory isolated steatosis to Non-Alcoholic Steatohepatitis (NASH), a more aggressive form of the disease, which is distinguished by steatosis, inflammatory changes and varying degrees of liver fibrosis to end-stage liver disease. Furthermore, NAFLD may be complicated by cirrhosis or Hepatocellular Carcinoma (HCC). It is now set to become the major cause of liver transplantation in adults as it is the most important cause of cryptogenic cirrhosis. The pathogenesis of NAFLD is multifactorial but is not fully elucidated. This session will explore the current understanding of this serious global health problem, the management strategies including bariatric surgery and the potential future therapeutic agents.