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N o v e m b e r 2 3 - 2 4 , 2 0 1 8 | B a n g k o k , T h a i l a n d
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Pharma Summit 2018 & Gastro Summit 2018 Asian Journal of Biomedical and Pharmaceutical Sciences | ISSN: 2249-622X | Volume 8
&
GLOBAL PHARMA SUMMIT
GASTROENTEROLOGY AND HEPATOLOGY
2nd International Conference on
Joint Event on
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
YEARS
David H Van Thiel, Asian J Biomed Pharmaceut Sci 2018, Volume 8 | DOI: 10.4066/2249-622X-C5-013
THE NAFLD CONUNDRUM: HOW TO
DISTINGUISH NAFLD FROM NASH
UTILIZING A NOVEL BIOMARKER WITHOUT
A LIVER BIOPSY
NAFLD is a liver disease characterized by increased hepatic fat with a global
prevalence of 25.24%. NASH is characterized as having varying degrees
of fat and inflammation within the liver. Both can progress to cirrhosis and he-
patocellular carcinoma. This progression is faster and occurs more frequently
with NASH than NAFLD. The healthcare burden of NAFLD in terms of health
care costs because of the number of hospital admissions per patient, the se-
verity of the liver disease, liver disease mortality, and non-liver disease mor-
tality with the progression of NAFLD to NASH with or without cirrhosis. Thus,
it is important to distinguish between NAFLD and NASH. A host of combined
hematologic and serologic measures using various algorithms have been
used for this purpose with variable and only modest success. Bore recently,
ultrasound assessments using transient or shear wave (SWE) have been used
for this purpose with the latter having the advantage of estimating the hepatic
fat content determined by the hepato-renal ratio (HRR). SWE is more available,
cheaper, and less demanding in terms of time commitment and experience as
compared to MRE which is only available at a few research centers.
Aim: To identify a serologic marker that identifies those with NASH from those
with NAFLD.
Methods: A total of 105 patients were investigated using SWE utilizing an Aix-
plorer Ultimate Supersonic Image Shear Wave unit. 30 “normal” controls with-
out fatty liver disease, 15 with NAFLD and 3 with NASH with all 3 groups being
matched for the following factors, BMI, type 2 diabetes mellitus, hypertension,
hyperlipidemia presence of clinical sleep apnea.
Results: The only laboratory parameter that identified those with NASH as dis-
tinct from those with NAFLD was at the plasma level of leptin.
Conclusion: The plasma level of leptin distinguish is individuals with NASH
from those with or without NAFLD
Biography
David H Van Thiel graduated from the University
of California at Los Angeles in medicine. He com-
pleted 2 years of postgraduate education at Cornell
University Hospitals in New York City followed by 2
years at the NIH in Bethesda Maryland an addition-
al 2 years at Boston University in medicine in gas-
troenterology. He completed a second year of gas-
troenterology/hepatology fellowship and joined
the faculty at the University of Pittsburgh where
he spent the next 20 years as director of Gastro-
enterology and Hepatology, Medical director of the
Liver Transplant Program, and achieved the rank
of professor of medicine and surgery. He served
as the President of the AASLD. RSA and Midwest
Federation of Clinical Research. He was critical to
the development of 6 distinguished liver transplant
programs in US serving as the Medical director at
each. He has published over 1100 peer reviewed
manuscripts in gastroenterology, hepatology, en-
docrinology, as well as others. He was awarded
the Albert Nelson Marquis Lifetime Achievement
Award in 2017.
David H Van Thiel
Rush University, USA