About sixty drugs are being evaluated to treat the disease, but the hygieno-dietetic rules remain the cornerstone of care.
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Otherwise called “foie gras disease” or “soda disease”, Nafld (Non Alcoholic Fatty Liver Disease or Non-Alcoholic Hepatic Steatose) is an accumulation of fats in the liver >, mainly due to too rich diet and too much a sedentary lifestyle. According to a study carried out from the Constances cohort (Inserm), around 18 % of the adult population is concerned, between 8 to 10 million people. If this grease overload in the liver generally does not evolve, it will create inflammation in 20 % of cases, which can evolve in fibrosis, even cirrhosis or cancer.
This inflammatory form is called “non -alcoholic steathepatitis” (NASH). It would concern up to 200,000 people in France. In the most severe cases, a liver transplant is necessary.
“The challenge is to detect patients with a severe form of fibrosis. We must also educate general practitioners,” said Laurent Castera, of the hepatology department of Beaujon Hospital (AP-HP), to Clichy (Hauts-de-Seine), during a press point on the occasion of Paris Nash Meeting, which was held in Paris on September 8 and 9. if this specialist reassures by saying that “most people who have a foie gras will not evolve towards a form Serious, screening is important because these diseases progress slowly and give few symptoms. ” This involves a blood dosage of transaminases (liver enzymes), an ultrasound or a fibroscan, a non -invasive examination which makes it possible to measure the elasticity of the liver.
Improve cardiometabolic health
Type 2 diabetics are concerned in the first place: almost 60 % of them have steatosis, and the frequency of severe fibrosis is 7 %. For the time being, learned societies recommend screening in diabetic patients, but also in obese people or with metabolic syndrome and, conversely, to seek type 2 diabetes in patients with hepatic steatosis.
As for treatment, there is no drug available. The cornerstone is based on hygieno-dietetic rules (physical activity, more balanced, less fatty food, less sweet), the challenge being to improve cardio-metabolic health.
About sixty molecules are being evaluated, with some three hundred clinical trials worldwide, announced Lawrence Serfaty, head of the hepatology department of Hautepierre hospital in Strasbourg and president of this Nash meeting conference .
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