The Liver Meeting 2022-NAFLD Debrief

Video Transcription

Video Summary

In this video, Dr. Anna Mae Diehl, a professor of medicine, provides a summary of the recent research presented at the meeting on non-alcoholic fatty liver disease (NAFLD). She starts by discussing some randomized controlled trials that showed efficacy in treating NAFLD using analogs of FGF21, p-agglutazine, and beta-chloric acid. Then she moves on to talk about the impact of social determinants of health on incident outcomes in metabolic liver disease. She mentions a study that found affluence to be an independent risk factor for overall and liver-related mortality in NAFLD patients. Another study looked at how neighborhood resources affect pediatric NAFLD prevalence and found that social determinants of health play a significant role. Next, Dr. Diehl talks about the role of body weight in NAFLD and discusses a new uncoupling agent called HU6 that showed promising results in reducing liver and whole body fat. She also mentions a mobile health-delivered lifestyle intervention program called NOOM that was effective in inducing weight loss and improving physical activity in NAFLD patients. Moving on to diabetes, she discusses two studies that found a higher rate of fibrosis progression in NAFLD patients with diabetes compared to those without diabetes. In addition, she mentions a study that found a significant association between chronic kidney disease and NAFLD, suggesting that systematic screening of older diabetic populations may be necessary. Next, Dr. Diehl talks about the use of non-invasive tests for diagnosing and predicting outcomes in NAFLD. She discusses two studies that looked at the use of transient elastography (VCTE) and found it to be an independent predictor of liver cancer, liver failure, and poor clinical outcomes in NAFLD patients. She also talks about the limitations of using FT-Four as a non-invasive test for identifying individuals with at-risk NASH and concludes that FT-Four may underestimate fibrosis severity. Another study looked at the combination of seromarkers and imaging and found that adding VCTE to AST was the most accurate way to identify fibrotic NASH in diabetics. In pediatric populations, kid-specific non-invasive tests were found to be more accurate than standard tests used in adults. Dr. Diehl then discusses the role of the liver microbiome in NAFLD and how differences in the microbiome could explain differences in NAFLD pathogenesis. She mentions a study that found correlations between liver bacteria and liver protein acetylation, which in turn correlated with differences in severity of steatosis, liver damage, and blood glucose. Another study looked at the impact of advanced glycosylation endproducts (AGEs) on liver matrix properties and found that AGEs increased viscoelasticity, which could promote liver cancer growth. Moving on to basic science, Dr. Diehl discusses two studies that used single-cell analysis to characterize hepatic stellate cells and liver macrophages in NAFLD. The study on stellate cells identified genes that distinguish different stellate cell populations in NAFLD and could pave the way for new antifibrotic therapies. The study on macrophages found that metabolic abnormalities make them pro-inflammatory in NASH, but reprogramming their metabolism could make them anti-inflammatory and improve the condition. Overall, Dr. Diehl's summary highlights the diverse research presented at the meeting and provides valuable insights into the current understanding of NAFLD.

Asset Caption

Presented by Dr. Anna Mae Diehl, Duke University Medical Center, United States

The goal of the NAFLD debrief is to briefly summarize some of the most provocative and impactful NAFLD research that was presented during AASLD.

Keywords

NAFLD

randomized controlled trials

social determinants of health

body weight

diabetes

non-invasive tests

liver microbiome