The Center released new guidelines and training manual for the management of cases of Non-Alcoholic Fatty Liver Disease (NAFLD). NAFLD patients are increasing alarmingly in India. The new measures focus on lifestyle changes and greater focus on early diagnosis and treatment of chronic conditions.
NAFLD can cause serious diseases to develop in the body.
The guidelines have been issued as part of the National Program for the Prevention and Control of Cancer, Diabetes, Heart Disease and Stroke (NPCDCS), as NAFLD is associated with obesity, type 2 diabetes, dyslipidemia or high cholesterol, high blood pressure, coronary artery disease. Disease and is closely linked to many cancers.
Why does this disease occur?
This liver disease is caused by the accumulation of excess fat in the liver cells, not necessarily due to excessive alcohol consumption as was the case a few decades ago. And while it is normal to have some fat in the liver, if it If it is more than 5 percent of the organ’s weight, it is called fatty liver or steatosis. The disease includes a variety of conditions, ranging from simple fatty liver (NAFL or simple steatosis) to non-alcoholic steatohepatitis (NASH). In NAFL, hepatic steatosis is present without evidence of any significant inflammation, whereas in NASH, hepatic steatosis is associated with hepatic inflammation. Persistent inflammation and liver cell damage in individuals with NASH can lead to liver fibrosis, characterized by the accumulation of scar tissue.
30-40 percent of cancer cases in India due to NAFLD
Over time, advanced fibrosis can progress to cirrhosis, a serious stage associated with liver dysfunction and complications such as liver failure and liver cancer. It is estimated that 30-40 percent of liver cancer cases in India are due to NAFLD. The new guidelines prepared by a 13-member expert panel headed by Director General of Health Services Dr Atul Goyal and senior hepatologist Dr SK Sarin said that since the condition predates many non-communicable diseases and has a two-way relationship with them, Therefore, its prevention and control requires a strong primary care component. Sarin, director of the Delhi-based Institute of Liver and Biliary Sciences, said this is a remarkable step and its results will be visible in the next few years. The last guidelines on NAFLD management were released in 2021.
Abdominal obesity is the most dangerous
Excess body weight, especially abdominal obesity, is a significant risk factor for NAFLD because the accumulation of fat around the abdomen contributes to insulin resistance and liver inflammation. Additionally, this condition is often seen in individuals with metabolic syndrome (a group of health problems that increase the risk of heart disease, diabetes, stroke, etc.), and has been seen in 60-90 percent of obese people. The new recommendations state that the disorder is also seen in 40-80 percent of people with type 2 diabetes mellitus, while lack of physical activity and a sedentary lifestyle are also linked to the development and progression of the disease.
Risk higher in middle-aged and older adult men
The risk is higher in middle-aged and older adult men, and certain medications (such as corticosteroids, tamoxifen) and certain medical conditions are classified as other risk factors.
One third of the world’s adults affected
NAFLD is the most common chronic liver disease worldwide, estimated to affect one third of adults worldwide. According to the latest estimates from the Union Health Ministry, its estimated prevalence in India ranges between 9 to 53 percent. Previous estimates for 2021 had suggested its prevalence in India to be between 9 and 32 percent.