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

Jeffrey V Lazarus, Henry E Mark, Quentin M Anstee, Juan Pablo Arab, Rachel L Batterham, Laurent Castera, Helena Cortez-Pinto, Javier Crespo, Kenneth Cusi, M Ashworth Dirac, Sven Francque, Jacob George, Hannes Hagström, Terry T-K Huang, Mona H Ismail, Achim Kautz, Shiv Kumar Sarin, Rohit Loomba, Veronica Miller, Philip N Newsome, Michael Ninburg, Ponsiano Ocama, Vlad Ratziu, Mary Rinella, Diana Romero, Manuel Romero-Gómez, Jörn M Schattenberg, Emmanuel A Tsochatzis, Luca Valenti, Vincent Wai-Sun Wong, Yusuf Yilmaz, Zobair M Younossi, Shira Zelber-Sagi

Journal: Nature reviews. Gastroenterology & hepatology 2022;19(1):60-78

PMID: 34707258

Abstract

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.

© 2021. Springer Nature Limited.

Address: Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain. [email protected].; EASL International Liver Foundation, Geneva, Switzerland. [email protected].; EASL International Liver Foundation, Geneva, Switzerland.; Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.; Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.; Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.; Centre for Obesity Research, University College London and National Institute of Health Research, UCLH Biomedical Research Centre, London, UK.; Department of Hepatology, Hôpital Beaujon, Université de Paris, Paris, France.; Clínica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.; Gastroenterology and Heptology Unit, Hospital Universitario Marqués de Valdecilla, Santander, IDIVAL, Santander, Spain.; Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Veterans Health Administration and University of Florida, Gainesville, FL, USA.; Department of Health Metrics Sciences, Department of Family Medicine, University of Washington, Seattle, WA, USA.; Department of Gastroenterology Hepatology, University Hospital Antwerp, Antwerp, Belgium.; Translational Sciences in Inflammation and Immunology TWI2N, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.; Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia.; Department of Medicine, Karolinska Institutet, Stockholm, Sweden.; Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA.; Division of Gastroenterology, Department of Internal Medicine, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.; Kautz5, Köln, Germany.; Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.; Department of Medicine, NAFLD Research Center, La Jolla, CA, USA.; Department of Medicine, University of California San Diego, La Jolla, CA, USA.; University of California Berkeley, School of Public Health, Forum for Collaborative Research, Washington, DC, USA.; National Institute for Health Research Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.; Hepatitis Education Project, Seattle, WA, USA.; Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.; Assistance Publique-Hôpitaux de Paris, Hôpital Pitie-Salpetriere, University of Paris, Paris, France.; Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.; Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA.; UCM Digestive Diseases, CIBEREHD and IBIS, Virgen del Rocío University Hospital, University of Seville, Seville, Spain.; Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany.; University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.; Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK.; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.; Precision Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.; Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey.; Liver Research Unit, Institute of Gastroenterology, Marmara University, Istanbul, Turkey.; Center for Liver Diseases, Inova Medicine, Falls Church, VA, USA.; University of Haifa, Faculty of Social Welfare and Health Sciences, School of Public Health, Mount Carmel, Haifa, Israel.; Department of Gastroenterology, Tel-Aviv Medical Centre, Tel-Aviv, Israel.
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