Approximately 37% of adults, and as many as 70% of individuals with type 2 diabetes (T2D), have nonalcoholic fatty liver disease (NAFLD). Nonalcoholic steatohepatitis (NASH), a subtype of NAFLD characterized by inflammation, ballooning, and Mallory’s hyaline on liver biopsy, can lead to hepatic fibrosis, cirrhosis, and hepatocellular cancer (HCC). Both NAFLD and NASH are also associated with an increased risk of cardiovascular disease, cardiovascular and liver-related mortality, and impaired health-related quality of life.
fibrosis
Screening for Advanced Hepatic Fibrosis Related to NAFLD/NASH
Hepatic fibrosis is the most important determinant of liver and non-liver outcomes in patients with nonalcoholic fatty liver disease (NAFLD). Therefore, identifying patients with clinically significant hepatic fibrosis (fibrosis stage 2 or higher) is important for targeted efforts at preventing disease progression.
Nonalcoholic steatohepatitis (NASH), a subtype of NAFLD characterized by inflammation, ballooning, and Mallory’s hyaline on liver biopsy, can lead to hepatic fibrosis, cirrhosis, and hepatocellular cancer (HCC). Both NAFLD and NASH are also associated with an increased risk of cardiovascular disease, cardiovascular and liver-related mortality, and impaired health-related quality of life.
Fibrosis-4 (FIB4) Scoring System for Liver Fibrosis
The FIB4 index was developed in 2006 by Sterling as a non-invasive method to diagnose liver fibrosis and combines aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels, platelet count, and age.
Diagnostic Criteria for Cystic Fibrosis
Cystic Fibrosis (CF) is a multisystem disorder caused by mutations in the gene for the CF transmembrane conductance regulator (CFTR), which encodes an ion channel protein, with more than 2000 mutations identified to date. A diagnosis of CF initially relied on phenotype, with clinical recognition of characteristic signs and symptoms.
Diagnostic Criteria for Idiopathic Pulmonary Fibrosis (IPF)
In 2000, IPF was defined as a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown cause, occurring primarily in older adults and limited to the lungs. Usual interstitial pneumonia (UIP) is the histopathological pattern of IPF. IPF is characterized by progressive worsening of dyspnea and lung function and is associated with a poor prognosis.
ATS/ERS Criteria for Diagnosis of Idiopathic Pulmonary Fibrosis (IPF)
Idiopathic interstitial pneumonias (IIPs) are part of a broad, heterogeneous group of interstitial lung diseases that encompasses more than 200 acute or chronic diseases with varying degrees of inflammation or fibrosis.
Diagnostic Criteria for Cystic Fibrosis (CF)
The diagnosis of cystic fibrosis is based on clinical signs and symptoms consistent with the disease and objective evidence of cystic fibrosis transmembrane conductance regulator (CFTR) dysfunction.
One or more typical phenotypic features of CF:
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Chronic sinopulmonary disease
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Characteristic gastrointestinal and nutritional abnormalities
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Salt loss syndromes
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Obstructive azoospermia
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