About this Research Topic
This Research Topic focuses on the themes of the 2020 Keystone Symposium Obesity and NAFLD: Mechanisms and Therapeutics.
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver condition in developed countries and aﬀects 20-40% of the general population. A major risk factor for NAFLD is obesity, which now aﬀects 25-30% of individuals worldwide. NAFLD involves a spectrum of liver diseases that range from simple steatosis to its progressive form, non-alcoholic steatohepatitis (NASH). Around 25-30% of patients with NAFLD have NASH, which may lead to the development of cirrhosis and its complications, such as portal hypertensive bleeding, hepatocellular carcinoma, and hepatic decompensation.
One of the ﬁrst metabolic defects that occurs during the development of NAFLD is hepatic lipid accumulation (steatosis), with this 'lipotoxic' state further driving inﬂammation and ﬁbrosis within the liver. Therefore, tackling such early metabolic defects (ie. inhibiting hepatic steatosis) is likely to have the capacity to prevent NASH development. However, despite NAFLD being one of the most common metabolic diseases in developed countries, there are currently no approved therapies for NASH and no therapies that directly target lipid accumulation and ﬁbrosis.
In addition to obesity, NAFLD increases the risk of developing type 2 diabetes (T2D) by 3-5 fold, which is associated with increased severity of micro- and macrovascular complications in T2D patients with NAFLD compared to those without a fatty liver. On the other hand, the presence of T2D significantly increases the risk of developing NAFLD, which highlights the bi-directional nature of the metabolic impact of T2D and NAFLD.
This Research Topic will focus on understanding NASH development, the prevalence of metabolic co-morbidities in NASH patients (with a focus on obesity and T2D), and therapeutic strategies for hepatic steatosis, NASH, and fibrosis.
Keywords: keystone, obesity, NASH
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