NASHIDA

NAFLD is a growing health concern and liver fibrosis severity determines its prognosis. The burden of this disease has been estimated in a quarter of the European population and is even higher in diabetic patients, where it raises significantly and can reach up to 80%. 

Non-alcoholic fatty liver disease (NAFLD) prevalence currently ranges from 20-30% of the overall population and  is expected to reach up to 50% by 2030 due to the large epidemic of diabetes and obesity - two major drivers for this disease. NAFLD progresses to cirrhosis over 20-30%, although there are different patterns of progression depending on the underlying risk factors. Diabetes mellitus, insulin resistance, arterial hypertension, obesity, waist circumference, and age have been proposed to shorten the fibrosis evolution rate.

The fact that only 10% of these patients will develop significant fibrosis, the strongest predictor of liver-specific morbidity and overall mortality, leads to an overwhelming situation in primary care and endocrine units, where physicians need to screen large numbers of patients to identify individuals with a high risk for developing fibrosis that should be derived to a specialized hepatology unit. New free and accurate non- invasive tests need to be available to be used in primary care and non-hepatologists units to fight against this disappointing situation.

Accurate fibrosis assessment by primary care or non-hepatologists physicians is limited by a reliance on liver function tests, which correlate poorly with fibrosis, and limited access to discriminatory fibrosis tests. Patients with advanced fibrosis or cirrhosis who would benefit from NAFLD specific interventions often remain undetected until they present with complications of cirrhosis, including hepatocellular carcinoma. This ineffective management contributes to the poor outcomes associated with liver disease and the increasing trends in NAFLD- related morbidity and mortality.