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1. Bothersome symptoms at midlife in relation to body fat percentage.

Author

Gerber LM, Whitcomb BW, Verjee MA, and Sievert LL

Subjects
Humans, Middle Aged, Female, Cross-Sectional Studies, Qatar epidemiology, Adult, Adipose Tissue, Obesity epidemiology
Abstract

Objectives: Increasing obesity has been associated with a higher frequency of symptoms at midlife. Bothersomeness represents an important measure of perceived symptom severity, but has received relatively little consideration, and relationships between symptom bothersomeness and obesity are not known. We evaluated the association between body fat percentage (%BF) and the bothersomeness of symptoms at midlife., Methods: This cross-sectional study included women aged 40-60 in Qatar (n = 841). Participants reported frequency and bothersomeness of midlife symptoms hypothesized to be related to body composition. Initially, we characterized the relationship between continuous %BF and presence (yes/no) and bothersomeness (yes/no) for each symptom using restricted cubic spline (RCS) models to test nonlinearity. Subsequently, we used multinomial logistic regressions to evaluate associations between %BF and multilevel symptom outcomes, where categories were: (a) no symptoms or bother, (b) symptoms without bothersomeness, and (c) symptoms with bothersomeness., Results: The highest frequency of bothersomeness was reported for aches/stiffness in joints (51%), followed by trouble sleeping (34%), night sweats (21%), urinary incontinence (18%), hot flashes (16%), and shortness of breath (15%). In unadjusted multinomial logistic regressions, aches/stiffness in joints with and without bothersomeness had the same significant relationship with %BF. Bothersome night sweats, urinary incontinence, and hot flashes were significantly associated with %BF (p < .05), but those same symptoms without bothersomeness were not significantly associated with %BF., Conclusions: Our findings suggest that bothersomeness is an important variable that tracks with body fat and gives different information than report of the presence/absence of a symptom alone., (© 2024 Wiley Periodicals LLC.)

Published
2024
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2. Obesity is associated with increased prostate growth and attenuated prostate volume reduction by dutasteride.

Author

Muller RL, Gerber L, Moreira DM, Andriole G Jr, Hamilton RJ, Fleshner N, Parsons JK, and Freedland SJ

Subjects
Aged, Biopsy, Body Mass Index, Dutasteride, Humans, Linear Models, Logistic Models, Male, Middle Aged, Multivariate Analysis, Organ Size, Prostate diagnostic imaging, Prostate pathology, Prostatic Hyperplasia complications, Prostatic Hyperplasia pathology, Treatment Outcome, Ultrasonography, 5-alpha Reductase Inhibitors therapeutic use, Azasteroids therapeutic use, Obesity complications, Prostatic Hyperplasia drug therapy, Prostatic Neoplasms prevention & control
Abstract

Background: Although obesity has been associated with larger prostate volumes (PV), few studies have actually investigated whether obesity enhances PV growth, especially among men using 5α-reductase inhibitors., Objective: To examine whether obesity is associated with enhanced PV growth measured by serial transrectal ultrasound (TRUS) measurements., Design, Setting, and Participants: We conducted a secondary analysis of the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial, which was originally aimed at cancer risk reduction among high-risk men with a single negative prestudy biopsy., Intervention: Per-protocol randomization to placebo or dutasteride and mandatory TRUS-guided biopsies at 2 yr and 4 yr., Outcome Measurements and Statistical Analysis: Percentage change in PV at 2 yr and 4 yr from baseline. We tested its association with baseline body mass index (BMI) groups of <25, 25-29.9, and ≥ 30 kg/m(2) using multivariable linear regression. Secondarily, we tested whether BMI was associated with the likelihood of having no PV reduction among men randomized to dutasteride using multivariable logistic regression., Results and Limitations: Of 8122 participants, we analyzed 71.8% and 54.5% with complete 2-yr and 4-yr PV data, respectively. In multivariable analysis, men on placebo with BMI ≥ 30 versus < 25 kg/m(2) had enhanced PV growth from baseline (at 2 yr: 17.0% vs 10.7%, p<0.001; at 4 yr: 29.4% vs 20.1%; p=0.001). Men on dutasteride with BMI ≥ 30 versus < 25 kg/m(2) had attenuated PV reduction from baseline (at 2 yr: -14.3% vs -18.5%; p=0.002; at 4 yr: -13.2% vs -19.3%; p=0.001) and higher likelihood of having no PV reduction (at 2 yr: odds ratio [OR]: 1.44; 95% confidence interval [CI], 1.08-1.93; p=0.014; at 4 yr: OR: 1.62; 95% CI, 1.18-2.22; p=0.003). We found no significant interactions between BMI and dutasteride on PV change at 2 yr and 4 yr (p interaction ≥ 0.36). No clinical outcomes or effects of weight change were assessed., Conclusions: Obesity enhanced PV growth and attenuated PV reduction by dutasteride. The null interaction between obesity and dutasteride for PV change implies that the effect of obesity on dutasteride-treated men is likely a combination of dutasteride-driven PV reduction with obesity-driven PV growth rather than decreased dutasteride efficacy., (Copyright © 2013 European Association of Urology. All rights reserved.)

Published
2013
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3. Obesity, prostate-specific antigen nadir, and biochemical recurrence after radical prostatectomy: biology or technique? Results from the SEARCH database.

Author

Ho T, Gerber L, Aronson WJ, Terris MK, Presti JC, Kane CJ, Amling CL, and Freedland SJ

Subjects
Aged, Body Mass Index, Humans, Linear Models, Male, Middle Aged, Multivariate Analysis, Obesity diagnosis, Proportional Hazards Models, Prostatic Neoplasms blood, Prostatic Neoplasms complications, Prostatic Neoplasms pathology, Recurrence, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, United States, United States Department of Veterans Affairs, Kallikreins blood, Obesity complications, Prostate-Specific Antigen blood, Prostatectomy adverse effects, Prostatic Neoplasms surgery
Abstract

Background: Obesity is associated with an increased risk of biochemical recurrence (BCR) after radical prostatectomy (RP). It is unclear whether this is due to technical challenges related to operating on obese men or other biologic factors., Objective: To examine whether obesity predicts higher prostate-specific antigen (PSA) nadir (as a measure of residual PSA-producing tissue) after RP and if this accounts for the greater BCR risk in obese men., Design, Setting, and Participants: A retrospective analysis of 1038 RP patients from 2001 to 2010 in the multicenter US Veterans Administration-based Shared Equal Access Regional Cancer Hospital database with median follow-up of 41 mo., Intervention: All patients underwent RP., Outcome Measurements and Statistical Analysis: We evaluated the relationship between body mass index (BMI) and ultrasensitive PSA nadir within 6 mo after RP. Adjusted proportional hazards models were used to examine the association between BMI and BCR with and without PSA nadir., Results and Limitations: Mean BMI was 28.5 kg/m2. Higher BMI was associated with higher PSA nadir on both univariable (p=0.001) and multivariable analyses (p<0.001). Increased BMI was associated with increased BCR risk (hazard ratio [HR]: 1.06; p=0.007). Adjusting for PSA nadir slightly attenuated, but did not eliminate, this association (HR: 1.04, p=0.043). When stratified by PSA nadir, obesity only significantly predicted BCR in men with an undetectable nadir (p=0.006). Unfortunately, other clinically relevant end points such as metastasis or mortality were not available., Conclusions: Obese men are more likely to have a higher PSA nadir, suggesting that either more advanced disease or technical issues confound an ideal operation. However, even after adjusting for the increased PSA nadir, obesity remained predictive of BCR, suggesting that tumors in obese men are growing faster. This provides further support for the idea that obesity is biologically associated with prostate cancer progression., (Published by Elsevier B.V.)

Published
2012
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4. Predictive value of digital rectal examination for prostate cancer detection is modified by obesity.

Author

Chu DI, De Nunzio C, Gerber L, Thomas JA 2nd, Calloway EE, Albisinni S, Senocak C, McKeever MG, Moreira DM, Tubaro A, Moul JW, Freedland SJ, and Bañez LL

Subjects
Aged, Body Mass Index, Cohort Studies, Humans, Italy epidemiology, Male, Middle Aged, Predictive Value of Tests, Prostatic Neoplasms complications, Prostatic Neoplasms epidemiology, Risk, United States epidemiology, Digital Rectal Examination, Early Detection of Cancer, Obesity complications, Prostatic Neoplasms diagnosis
Abstract

The American Cancer Society's updated screening guidelines for prostate cancer (CaP) render digital rectal examination (DRE) optional. We investigated the impact of DRE on CaP detection among obese men. Data from 2794 men undergoing initial prostate biopsy at three centers were analyzed to assess CaP risk attributed to abnormal DRE across body mass index (BMI) categories. Predictive accuracies of a combination of PSA, age, race, center and biopsy year including or excluding DRE findings were compared by areas under the receiver-operating characteristics curves. In all cohorts, obese men were less likely to have abnormal DREs diagnosed than non-obese men. As BMI category increased, abnormal DREs became stronger predictors for overall CaP in individual (P-trends ≤ 0.05) and combined (P-trend<0.001) cohorts, and for high-grade CaP in the Italian (P-trend=0.03) and combined (P-trend=0.03) cohorts. DRE inclusion improved the predictive accuracy for overall and high-grade CaP detection among all obese men (P ≤ 0.032) but not normal-weight men (P ≥ 0.198). DRE inclusion also near-significantly improved overall CaP detection in obese men with PSA<4 ng ml(-1) (P=0.081). In conclusion, the predictive value of DRE is dependent on obesity and is significantly higher among obese men than normal-weight men.

Published
2011
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5. Association of leptin levels with obesity and blood pressure: possible common genetic variation.

Author

Livshits G, Pantsulaia I, and Gerber LM

Subjects
Adolescent, Adult, Aged, Anthropometry, Body Constitution, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Obesity physiopathology, Systole, Blood Pressure genetics, Leptin blood, Leptin genetics, Obesity blood, Quantitative Trait, Heritable
Abstract

Objective: To ascertain the extent to which relationships between obesity (OB) and blood pressure (BP) can be explained by an individual's leptin plasma levels., Design: Pedigree-based cross-sectional study in an apparently healthy population of European origin., Subjects: The study sample is comprised of 90 nuclear and more complex families totaling 210 male and 213 female subjects aged 18-75 y, randomly recruited in Bashkorstan Autonomic region, Russia., Measurements: Various fatness and fat distribution traits (including nine circumferences (CRCs), and eight skinfolds (CKFs) by anthropometry), blood pressure, and plasma leptin levels (by ELISA kits)., Results: Adjustment for circulating leptin led to attenuation of the magnitude of correlations between OB and BP, regardless of trait pair and sex cohort. Some of these correlations became statistically nonsignificant. All familial effects were gone, and heritability estimates became virtually zero after adjustment of each of the OB traits and systolic blood pressure (SBP) in offspring for leptin values in parents., Conclusion: BP and OB covariation is substantially mediated by circulating leptin levels. As a result, body fat has only a weak independent effect on BP variation after adjustment for leptin levels. Our findings also strongly suggest that genetic variation in body mass index, SKFs, and even body CRCs, as well as of SBP is due to genetic variation of leptin. Genetic variation of diastolic blood pressure in the present sample, however, shared very little with that of leptin.

Published
2005
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7. Advancing the global public health agenda for NAFLD: a consensus statement

Author

Lazarus, Jeffrey V., Mark, Henry E., Anstee, Quentin M., Arab, Juan Pablo, Batterham, Rachel L., Castera, Laurent, Cortez-Pinto, Helena, Crespo, Javier, Cusi, Kenneth, Dirac, M. Ashworth, Francque, Sven, Hickman, Ingrid J., Hocking, Samantha L., Hunyady, Bela, Idilman, Ramazan, Isakov, Vasily A., Jamal, Mohammad H., Jepsen, Peter, Iskandar, Natacha Jreige, Song, Myeong Jun, Sudhamshu, K. C., George, Jacob, Kakizaki, Satoru, Kalamitsis, George, Kanwal, Fasiha, Kao, Jia-Horng, Kaplan, Lee, Kawaguchi, Takumi, Khader, Yousef, Kim, Seung Up, Kodjoh, Nicolas, Koek, Ger, Hagström, Hannes, Koike, Kazuhiko, Komas, Narcisse Patrice, Korenjak, Marko, Kugelmas, Marcelo, Labidi, Asma, Lange, Naomi F., Lavine, Joel E., Lazo, Mariana, Lee, Nancy, Lesmana, Cosmas Rinaldi A., Huang, Terry T.-K., Liu, Chun-Jen, Long, Michelle T., Lopez-Jaramillo, Patricio, Malekzadeh, Reza, Mahtab, Mamun Al, Marchesini, Giulio, Marinho, Rui, Vázquez, Sophia E. Martínez, Mateva, Lyudmila, Nlombi, Charles Mbendi, Ismail, Mona H., Melin, Pascal, Mikolasevic, Ivana, Milovanovic, Tamara, Musso, Carla, Nakajima, Atsushi, Nava, Edna, Nersesov, Alexander V., Nikolova, Dafina, Norris, Suzanne, Novak, Katja, Kautz, Achim, Oben, Jude, Ong, Janus P., Onyekwere, Charles, Papatheodoridis, George, Paruk, Imran, Patel, Keyur, Macedo, M. Paula, Penha-Gonçalves, Carlos, Figueroa, Marlene Pérez, Hofmann, Wolf Peter, Sarin, Shiv Kumar, Petta, Salvatore, de Oliveira, Claudia Pinto Marques Souza, Puri, Puneet, Pan, Calvin Q., Rac, Marek, Ralston, Johanna, Ramji, Alnoor, Razavi, Homie, Alvares-da-Silva, Mario Reis, Roberts, Stuart, Loomba, Rohit, Roden, Michael, Rose, Tamsin, Rouabhia, Samir, Rovere-Querini, Patrizia, Rowe, Ian A., Sadirova, Shakhlo, Salupere, Riina, Saparbu, Tobokalova, Sayegh, Raymond, Sebastiani, Giada, Miller, Veronica, Seki, Yosuke, Selmo, Josefina, Serme, Abdel Karim, Shaw, Jonathan E., Shenoy, Thrivikrama, Sheron, Nick, Shibolet, Oren, Silva, Marcelo, Skrypnyk, Igor, Socha, Piotr, Newsome, Philip N., Soriano, Joan, Spearman, C. Wendy, Sridharan, Kannan, Suárez, Juan José, Sheriff, Dhastagir Sultan, Sung, Ki-Chul, Swain, Mark, Tacke, Frank, Taheri, Shahrad, Tan, Soek-Siam, Ninburg, Michael, Tapper, Elliot B., Yki-Järvinen, Hannele, Thiele, Maja, Shawa, Isaac Thom, Tolmane, Ieva, Torres, Esther A., Trauner, Michael, Treeprasertsuk, Sombat, Turcanu, Adela, Valantinas, Jonas, Ocama, Ponsiano, Vesterhus, Mette, Waked, Imam, Wild, Sarah H., Willemse, Jose, Wong, Robert J., Xanthakos, Stavra, Young, Dan Yock, Yu, Ming-Lung, Zheng, Kenneth I., Zeybel, Mudjat, Ratziu, Vlad, Zheng, Ming-Hua, Rinella, Mary, Romero, Diana, Romero-Gómez, Manuel, Schattenberg, Jörn M., Tsochatzis, Emmanuel A., Valenti, Luca, Wong, Vincent Wai-Sun, Yilmaz, Yusuf, Younossi, Zobair M., Zelber-Sagi, Shira, Åberg, Fredrik, Adams, Leon, Khatry, Maryam Salem Al, Naamani, Khalid Al, Murillo, Omar Alfaro, Allen, Alina M., Alnaser, Faisal, Alqahtani, Saleh A., Alswat, Khalid, Alvaro, Domenico, Andrade, Raúl J., Arrese, Marco, Awuku, Yaw Asante, Ayesha, Motala, Baatarkhuu, Oidov, Bakieva, Shokhista, Basu, Rita, Bataller, Ramon, Bedri, Shahinaz, Bosi, Emanuele, Bourliere, Marc, Bruha, Radan, Bugianesi, Elisabetta, Burra, Patrizia, Buti, Maria, Byrne, Christopher D., Calleja, Jose Luis, Carrieri, Patrizia, Carter, Flloyd, Fernandez, Marlen Ivon Castellanos, Castillo-Lopez, Gabriela, Castro-Narro, Graciela E., Chan, Henry Lik Yuen, Chan, Wah-Kheong, Chang, Yoosoo, Colombo, Massimo, Coppell, Kirsten J., Corey, Kathleen, Craxi, Antonio, Cryer, Donna, Dassanayake, Anuradha, Martins, Antonieta de Ascenção Soares, de Ledinghen, Victor, DelPrato, Stefano, Demaio, Alessandro, Desalegn, Hailemichael, Dillon, John, Duseja, Ajay, Dorairaj, Prabhakaran, Ekstedt, Mattias, El Kassas, Mohamed, Elsanousi, Osama M., Esmat, Gamal, Fan, Jian-Gao, Farpour-Lambert, Nathalie, Flisiak, Robert, Fouad, Yasser, Fuchs, Michael, Gani, Rino A., Gerber, Lynn, Ghazinyan, Hasmik, Gheorghe, Liana, Goh, George Boon-Bee, Grønbæk, Henning, Gulnara, Aghayeva, Hamid, Saeed, Hebditch, Vanessa, Repositório da Universidade de Lisboa, Masira, Lazarus, Jeffrey, V, Mark, Henry E., Anstee, Quentin M., Arab, Juan Pablo, Batterham, Rachel L., Castera, Laurent, Cortez-Pinto, Helena, Crespo, Javier, Cusi, Kenneth, Dirac, M. Ashworth, Francque, Sven, George, Jacob, Hagstrom, Hannes, Huang, Terry T-K, Ismail, Mona H., Kautz, Achim, Sarin, Shiv Kumar, Loomba, Rohit, Miller, Veronica, Newsome, Philip N., Ninburg, Michael, Ocama, Ponsiano, Ratziu, Vlad, Rinella, Mary, Romero, Diana, Romero-Gomez, Manuel, Schattenberg, Jorn M., Tsochatzis, Emmanuel A., Valenti, Luca, Wong, Vincent Wai-Sun, Yilmaz, Yusuf, Younossi, Zobair M., Zelber-Sagi, Shira, Lazarus, J. V., Mark, H. E., Anstee, Q. M., Arab, J. P., Batterham, R. L., Castera, L., Cortez-Pinto, H., Crespo, J., Cusi, K., Dirac, M. A., Francque, S., George, J., Hagstrom, H., Huang, T. T. -K., Ismail, M. H., Kautz, A., Sarin, S. K., Loomba, R., Miller, V., Newsome, P. N., Ninburg, M., Ocama, P., Ratziu, V., Rinella, M., Romero, D., Romero-Gomez, M., Schattenberg, J. M., Tsochatzis, E. A., Valenti, L., Wong, V. W. -S., Yilmaz, Y., Younossi, Z. M., Zelber-Sagi, S., Aberg, F., Adams, L., Khatry, M. S. A., Naamani, K. A., Murillo, O. A., Allen, A. M., Alnaser, F., Alqahtani, S. A., Alswat, K., Alvaro, D., Andrade, R. J., Arrese, M., Awuku, Y. A., Ayesha, M., Baatarkhuu, O., Bakieva, S., Basu, R., Bataller, R., Bedri, S., Bosi, E., Bourliere, M., Bruha, R., Bugianesi, E., Burra, P., Buti, M., Byrne, C. D., Calleja, J. L., Carrieri, P., Carter, F., Fernandez, M. I. C., Castillo-Lopez, G., Castro-Narro, G. E., Chan, H. L. Y., Chan, W. -K., Chang, Y., Colombo, M., Coppell, K. J., Corey, K., Craxi, A., Cryer, D., Dassanayake, A., Martins, A. A. S., de Ledinghen, V., Delprato, S., Demaio, A., Desalegn, H., Dillon, J., Duseja, A., Dorairaj, P., Ekstedt, M., El Kassas, M., Elsanousi, O. M., Esmat, G., Fan, J. -G., Farpour-Lambert, N., Flisiak, R., Fouad, Y., Fuchs, M., Gani, R. A., Gerber, L., Ghazinyan, H., Gheorghe, L., Goh, G. B. -B., Gronbaek, H., Gulnara, A., Hamid, S., Hebditch, V., Hickman, I. J., Hocking, S. L., Hunyady, B., Idilman, R., Isakov, V. A., Jamal, M. H., Jepsen, P., Iskandar, N. J., Song, M. J., Sudhamshu, K. C., Kakizaki, S., Kalamitsis, G., Kanwal, F., Kao, J. -H., Kaplan, L., Kawaguchi, T., Khader, Y., Kim, S. U., Kodjoh, N., Koek, G., Koike, K., Komas, N. P., Korenjak, M., Kugelmas, M., Labidi, A., Lange, N. F., Lavine, J. E., Lazo, M., Lee, N., Lesmana, C. R. A., Liu, C. -J., Long, M. T., Lopez-Jaramillo, P., Malekzadeh, R., Mahtab, M. A., Marchesini, G., Marinho, R., Vazquez, S. E. M., Mateva, L., Nlombi, C. M., Melin, P., Mikolasevic, I., Milovanovic, T., Musso, C., Nakajima, A., Nava, E., Nersesov, A. V., Nikolova, D., Norris, S., Novak, K., Oben, J., Ong, J. P., Onyekwere, C., Papatheodoridis, G., Paruk, I., Patel, K., Macedo, M. P., Penha-Goncalves, C., Figueroa, M. P., Hofmann, W. P., Petta, S., de Oliveira, C. P. M. S., Puri, P., Pan, C. Q., Rac, M., Ralston, J., Ramji, A., Razavi, H., Alvares-da-Silva, M. R., Roberts, S., Roden, M., Rose, T., Rouabhia, S., Rovere-Querini, P., Rowe, I. A., Sadirova, S., Salupere, R., Saparbu, T., Sayegh, R., Sebastiani, G., Seki, Y., Selmo, J., Serme, A. K., Shaw, J. E., Shenoy, T., Sheron, N., Shibolet, O., Silva, M., Skrypnyk, I., Socha, P., Soriano, J., Spearman, C. W., Sridharan, K., Suarez, J. J., Sheriff, D. S., Sung, K. -C., Swain, M., Tacke, F., Taheri, S., Tan, S. -S., Tapper, E. B., Yki-Jarvinen, H., Thiele, M., Shawa, I. T., Tolmane, I., Torres, E. A., Trauner, M., Treeprasertsuk, S., Turcanu, A., Valantinas, J., Vesterhus, M., Waked, I., Wild, S. H., Willemse, J., Wong, R. J., Xanthakos, S., Young, D. Y., Yu, M. -L., Zheng, K. I., Zeybel, M., Zheng, M. -H., NAFLD Consensus Consortium, Lazarus J.V., Mark H.E., Anstee Q.M., Arab J.P., Batterham R.L., Castera L., Cortez-Pinto H., Crespo J., Cusi K., Dirac M.A., Francque S., George J., Hagstrom H., Huang T.T.-K., Ismail M.H., Kautz A., Sarin S.K., Loomba R., Miller V., Newsome P.N., Ninburg M., Ocama P., Ratziu V., Rinella M., Romero D., Romero-Gomez M., Schattenberg J.M., Tsochatzis E.A., Valenti L., Wong V.W.-S., Yilmaz Y., Younossi Z.M., Zelber-Sagi S., Aberg F., Adams L., Khatry M.S.A., Naamani K.A., Murillo O.A., Allen A.M., Alnaser F., Alqahtani S.A., Alswat K., Alvaro D., Andrade R.J., Arrese M., Awuku Y.A., Ayesha M., Baatarkhuu O., Bakieva S., Basu R., Bataller R., Bedri S., Bosi E., Bourliere M., Bruha R., Bugianesi E., Burra P., Buti M., Byrne C.D., Calleja J.L., Carrieri P., Carter F., Fernandez M.I.C., Castillo-Lopez G., Castro-Narro G.E., Chan H.L.Y., Chan W.-K., Chang Y., Colombo M., Coppell K.J., Corey K., Craxi A., Cryer D., Dassanayake A., Martins A.A.S., de Ledinghen V., DelPrato S., Demaio A., Desalegn H., Dillon J., Duseja A., Dorairaj P., Ekstedt M., El Kassas M., Elsanousi O.M., Esmat G., Fan J.-G., Farpour-Lambert N., Flisiak R., Fouad Y., Fuchs M., Gani R.A., Gerber L., Ghazinyan H., Gheorghe L., Goh G.B.-B., Gronbaek H., Gulnara A., Hamid S., Hebditch V., Hickman I.J., Hocking S.L., Hunyady B., Idilman R., Isakov V.A., Jamal M.H., Jepsen P., Iskandar N.J., Song M.J., Sudhamshu K.C., Kakizaki S., Kalamitsis G., Kanwal F., Kao J.-H., Kaplan L., Kawaguchi T., Khader Y., Kim S.U., Kodjoh N., Koek G., Koike K., Komas N.P., Korenjak M., Kugelmas M., Labidi A., Lange N.F., Lavine J.E., Lazo M., Lee N., Lesmana C.R.A., Liu C.-J., Long M.T., Lopez-Jaramillo P., Malekzadeh R., Mahtab M.A., Marchesini G., Marinho R., Vazquez S.E.M., Mateva L., Nlombi C.M., Melin P., Mikolasevic I., Milovanovic T., Musso C., Nakajima A., Nava E., Nersesov A.V., Nikolova D., Norris S., Novak K., Oben J., Ong J.P., Onyekwere C., Papatheodoridis G., Paruk I., Patel K., Macedo M.P., Penha-Goncalves C., Figueroa M.P., Hofmann W.P., Petta S., de Oliveira C.P.M.S., Puri P., Pan C.Q., Rac M., Ralston J., Ramji A., Razavi H., Alvares-da-Silva M.R., Roberts S., Roden M., Rose T., Rouabhia S., Rovere-Querini P., Rowe I.A., Sadirova S., Salupere R., Saparbu T., Sayegh R., Sebastiani G., Seki Y., Selmo J., Serme A.K., Shaw J.E., Shenoy T., Sheron N., Shibolet O., Silva M., Skrypnyk I., Socha P., Soriano J., Spearman C.W., Sridharan K., Suarez J.J., Sheriff D.S., Sung K.-C., Swain M., Tacke F., Taheri S., Tan S.-S., Tapper E.B., Yki-Jarvinen H., Thiele M., Shawa I.T., Tolmane I., Torres E.A., Trauner M., Treeprasertsuk S., Turcanu A., Valantinas J., Vesterhus M., Waked I., Wild S.H., Willemse J., Wong R.J., Xanthakos S., Young D.Y., Yu M.-L., Zheng K.I., Zeybel M., and Zheng M.-H.

Subjects
medicine.medical_specialty, Civil society, Delphi method, MEDLINE, Nash, MULTIDISCIPLINARY APPROACH, Disease, LATIN-AMERICAN ASSOCIATION, Multidisciplinary approach, QUALITY-OF-LIFE, Non-alcoholic Fatty Liver Disease, Epidemiology, Medicine, Humans, POSITION STATEMENT, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, FATTY LIVER-DISEASE, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, Hepatology, business.industry, Public health, Gastroenterology, ALCOHOLIC STEATOHEPATITIS, NONINVASIVE DIAGNOSIS, medicine.disease, Obesity, CARDIOVASCULAR-DISEASE, PRACTICE GUIDELINES, Family medicine, PRACTICAL APPROACH, Human medicine, business
Abstract

Digital, Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver disease that affects approximately one-quarter of the global adult population, causing a substantial burden of ill health with wide-ranging social and economic implications. It is a multisystem disease and is considered the hepatic component of metabolic syndrome. Unlike other highly prevalent conditions, NAFLD has received little attention from the global public health community. Health system and public health responses to NAFLD have been weak and fragmented, and, despite its pervasiveness, NAFLD is largely unknown outside hepatology and gastroenterology. There is only a nascent global public health movement addressing NAFLD, and the disease is absent from nearly all national and international strategies and policies for non-communicable diseases, including obesity. In this global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved. The resulting consensus statements and recommendations address a broad range of topics — from epidemiology, awareness, care and treatment to public health policies and leadership — that have general relevance for policy-makers, health-care practitioners, civil society groups, research institutions and affected populations. These recommendations should provide a strong foundation for a comprehensive public health response to NAFLD., Ciencias Médicas y de la Salud

Published
2021

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