Seen TK, Sayed M, Bilal M, Reyes JV, Bhandari P, Lourdusamy V, Al-khazraji A, Syed U, Sattar Y, Bansal R. Clinical indicators for progression of nonalcoholic steatohepatitis to cirrhosis. World J Gastroenterol 2021; 27(23): 3238-3248 [PMID: 34163108 DOI: 10.3748/wjg.v27.i23.3238]
Corresponding Author of This Article
Ahmed Al-khazraji, MD, Academic Fellow, Division of Gastroenterology, Icahn School of Medicine, Elmhurst Hospital and Mount Sinai Hospital, 79-01 Broadway, Elmhurst, NY 11375, United States. alkhazra@nychhc.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 21, 2021; 27(23): 3238-3248 Published online Jun 21, 2021. doi: 10.3748/wjg.v27.i23.3238
Clinical indicators for progression of nonalcoholic steatohepatitis to cirrhosis
Tasur Kumar Seen, Muntazir Sayed, Muhammad Bilal, Jonathan Vincent Reyes, Priyanka Bhandari, Vennis Lourdusamy, Ahmed Al-khazraji, Umer Syed, Yasar Sattar, Raghav Bansal
Tasur Kumar Seen, Jonathan Vincent Reyes, Priyanka Bhandari, Yasar Sattar, Division of Internal Medicine, Icahn School of Medicine, Elmhurst Hospital and Mount Sinai Hospital, Elmhurst, NY 11375, United States
Muntazir Sayed, Division of Internal Medicine, R.C.S.M. Government College, Mahrashta 416013, India
Muhammad Bilal, Division of Gastroenterology, Hepatology and Endoscopy, Pakistan Institute of Medical Sciences, Islamabad 45710, Pakistan
Vennis Lourdusamy, Ahmed Al-khazraji, Umer Syed, Division of Gastroenterology, Icahn School of Medicine, Elmhurst Hospital and Mount Sinai Hospital, Elmhurst, NY 11375, United States
Raghav Bansal, Division of Gastroenterology, Icahn School of Medicine, Elmhurst Hospital, Elmhurst, NY 11375, United States
Author contributions: Seen TK wrote the final versions of the manuscript and did the final editing; Al Khazraji A, Lourdusamy V, Reyes JV and Bansal R assisted with the final editing; Reyes JV, Sayed M and Bilal M conducted the literature search and edited the original versions of the manuscript; Bhandari P, Syed U and Sattar Y conceived of the manuscript and wrote the first versions of the manuscript.
Conflict-of-interest statement: No individuals or any associated parties have any conflicts-of-interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmed Al-khazraji, MD, Academic Fellow, Division of Gastroenterology, Icahn School of Medicine, Elmhurst Hospital and Mount Sinai Hospital, 79-01 Broadway, Elmhurst, NY 11375, United States. alkhazra@nychhc.org
Received: October 24, 2020 Peer-review started: October 24, 2020 First decision: November 25, 2020 Revised: December 6, 2020 Accepted: April 20, 2021 Article in press: April 20, 2021 Published online: June 21, 2021 Processing time: 236 Days and 11.1 Hours
Abstract
Non-alcoholic fatty liver disease (NAFLD), is a disease spectrum characterized by fat accumulation in hepatocytes presenting as hepatic steatosis to advance disease with active hepatic inflammation, known as nonalcoholic steatohepatitis. Chronic steatohepatitis will lead to progressive hepatic fibrosis causing cirrhosis and increased risk for developing hepatocellular carcinoma (HCC). Fatty liver disease prevalence has increased at alarming rates alongside obesity, diabetes and metabolic syndrome to become the second most common cause of cirrhosis after alcohol related liver disease worldwide. Given this rise in prevalence, it is becoming increasingly more important to find non-invasive methods to diagnose disease early and stage hepatic fibrosis. Providing clinicians with the tools to diagnose and treat the full spectrum of NAFLD will help prevent known complications such as cirrhosis and HCC and improve quality of life for the patients suffering from this disease. This article discusses the utility of current non-invasive liver function testing in the clinical progression of fatty liver disease along with the imaging modalities that are available. Additionally, we summarize available treatment options including targeted medical therapy through four different pathways, surgical or endoscopic intervention.
Core Tip: Fatty liver disease rates along with obesity, diabetes and metabolic syndrome continue to increase and now is the second leading cause of cirrhosis secondary to alcohol related liver disease. The need for consistent and readily available methods to accurately diagnose and stage hepatic fibrosis becomes increasingly necessary. With an up to date armamentarium to diagnose and treat the full spectrum of non-alcoholic fatty liver disease will decrease complications such as cirrhosis and hepatocellular carcinoma and will improve the likelihood for patients to have a higher quality of life.
