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Patients with nonalcoholic fatty liver disease (NAFLD) may have normal alanine aminotransferase (ALT) levels in spite of having advanced fibrosis, according to a new study in the September issue of Hepatology, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases (AASLD). The article is available online at Wiley Interscience NAFLD is the hepatic expression of the metabolic syndrome and it can progress to cirrhosis, portal hypertension… Continue

Local documentary filmmaker Steven Greenstreet explored the local manifestation of a national phenomenon in his Michael Moore-vs.-Sean Hannity study This Divided State. His follow-up project paints a bigger picture of an even more serious subject: the national epidemic of obesity. And the most fascinating aspect of his approach is how complex he makes the issue—a tangle of biology, sociology, psychology and even politics that makes it hard to toss off the old “eat less and exercise” rejoinder. T… Continue

Is the clinical impact of nonalcoholic fatty liver disease (NAFLD) the Y2K of our specialty? Have we fashioned a mountain from a molehill of end-stage liver disease? The answer merits some consideration. Ian Wanless’s landmark cross-sectional study reported convincingly that the overall prevalence of NASH in adults in North America is 18.5% in obese and 2.7% in nonobese individuals.1 Of obese individuals found to have NASH at autopsy, about one in seven had bridging fibrosis or cirrhosis.… Continue

Most patients with a BMI of 30 or greater, and many with a BMI between 25 and 30, have at least… Continue

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