Non-alcoholic fatty liver disease screening, study underway
Almost one in three American adults, 90 million people, are living with non-alcoholic fatty liver disease (NAFLD). In some, this disease can progressively damage the liver, resulting in advanced scarring of the liver (cirrhosis) or liver cancer. Tragically, most adults with this disorder do not know they have it because there are no symptoms until it has progressed.
To raise public awareness of NAFLD, experts in Baylor College of Medicine’s and Baylor-St. Luke’s Medical Center’s Advanced Liver Therapies program have launched an awareness campaign to provide adult Houstonians with a free, FDA-approved ultrasound test that detects both fat and scarring in the liver. Currently, NAFLD is diagnosed only in people with abnormal elevations of liver enzymes on blood tests or an imaging study (ultrasound or CT scan) showing fat within the liver.
Free screening is available to those with any of the three main risk factors: 1) obesity or overweight; 2) diabetes or prediabetes; or 3) high lipids (cholesterol or triglyceride).
What is NAFLD?
Non-alcoholic fatty liver disease results from storage of abnormal amounts of fat within liver cells. In most people, this fat storage does not damage the liver. However, in a significant minority of people it triggers inflammation and scarring. This progressive form is called Non-Alcoholic Steatohepatitis, known as NASH. It produces a liver disease similar to that seen in people who drink excessive alcohol that can progress to cirrhosis or cancer.
“In most cases, patients with NASH have no symptoms and when first diagnosed may have already developed severe disease,” said Dr. John Vierling, professor of medicine and surgery, chief of hepatology at Baylor and director of Advanced Liver Therapies. “This is why it is so important that individuals be aware of the risk factors for NAFLD and take personal action to seek a diagnosis. To address the unmet needs for awareness of NAFLD and for diagnostic testing, we are providing a free ultrasound-based test that detects both fat and scarring within the liver.”
The screening is performed with an FDA-approved device called CAP-FibroScan. A probe is placed against the skin over the right rib cage and an ultrasonic wave is transmitted into the liver. The device uses the echo from this ultrasonic wave to detect the amount of fat and scar (fibrosis) within the liver.
Each participant is provided with a copy of his or her CAP-FibroScan results that can be used for future healthcare. There also is an option to participate in an informational study at Baylor by filling out a short questionnaire. The answers will help researchers better understand factors associated with NASH and how satisfied participants are with the screening program. In addition, everyone receives information about NAFLD, all current treatment options and a status report on all treatments being studied in FDA-approved clinical trials.
“We will gladly perform the CAP-FibroScan and provide the results, even if a person chooses not to join our informational study. The most important goal of this campaign is to provide awareness and diagnostic information about NAFLD to each participant,” Vierling said.
Are you at risk?
Risk factors for non-alcoholic fatty liver disease include obesity, type 2 diabetes or prediabetes and high cholesterol or triglycerides. These risk factors frequently occur with high blood pressure and a history of gout.
“Although many people know that liver disease occurs in people who drink too much alcohol, most do not know about NAFLD, even though the risk factors are common among American adults. Every adult must become aware of the risk factors for NAFLD and take action if they have these risk factors,” Vierling said.
Currently, the only proven effective therapy for NAFLD or NASH is sustained weight loss and control of other medical conditions, such as diabetes or high cholesterol or triglycerides. Weight loss, whether achieved through diet and exercise or bariatric surgery, can improve not only NAFLD or NASH, but also diabetes. However, Vierling noted that long-standing recommendations for weight loss through diet and exercise have been ineffective to date in lowering the rates of adult obesity, diabetes, elevated lipids and non-alcoholic fatty liver disease in adult Americans. Education, awareness and development of new treatments are crucial factors in the fight to identify and stop NAFLD before it progresses.