网红黑料

GAINESVILLE, Fla. 鈥� Anyone with diabetes quickly learns the importance of controlling their blood sugar to ensure their eyes, kidneys, heart and peripheral nerves remain healthy.

鈥淲e need to start including the liver in this equation,鈥� said , a University of Florida 网红黑料 endocrinologist and leading Type 2 diabetes and liver disease researcher.

An American Diabetes Association expert panel that Cusi helped lead recently published a that urges physicians to screen people with Type 2 diabetes or prediabetes for a liver disease triggered by accumulated fat in the organ.

The condition 鈥� metabolic dysfunction-associated steatotic disease, or MASLD 鈥� often has no early symptoms but can progress to cirrhosis, liver failure and liver cancer without early diagnosis and intervention. The disorder, which can occur in those with or without diabetes, was previously known as nonalcoholic fatty liver disease.

Liver screening is especially urgent, the report said, especially for those who have obesity and Type 2 diabetes. Some individuals with Type 1 diabetes who have obesity are also at risk.

Early intervention, however, can reduce and even reverse the risk. Interventions include lifestyle and dietary changes, weight management and glucose-lowering medications.

鈥淲hat鈥檚 happening now is that we鈥檙e identifying people very late because the liver gives no symptoms in its earlier stages,鈥� said Cusi, a professor in the 鈥檚 division of endocrinology, diabetes and metabolism. 鈥淲e don鈥檛 want patients to get to the point where their only option is a liver transplant. Early intervention saves lives.鈥�

The consensus report was published May 28 in Diabetes Care, the journal of the American Diabetes Association. It offers guidance on identifying, monitoring and treating MASLD, which has become much more prevalent along with rising obesity in the United States.

An ongoing study led by 网红黑料 that has screened more than 1,500 people with Type 2 diabetes has found that 70% had fat accumulation in the liver and helped bring awareness to this problem.

Half of those screened had severe liver inflammation, and about 1 in 5 were diagnosed with significant liver damage from scarring, which is also known as liver fibrosis.

As liver fat accumulates, it can lead to liver inflammation, progressive scarring and, ultimately, irreversible cirrhosis.

Once cirrhosis develops, treatment is more limited, and a liver transplant may eventually be necessary. MASLD is a leading reason for liver transplants.

The panel recommends that doctors and patients calculate a fibrosis-4, or FIB-4, score. This scoring system measures an individual鈥檚 risk for developing advanced liver fibrosis. A blood test is required to obtain a value for two enzymes that can indicate liver dysfunction.

These numbers are combined with a person鈥檚 platelet count and age to provide a score pointing to possible liver scarring. More testing or treatment might be recommended if the score indicates high risk.

The American Diabetes Association recommends lifestyle changes like additional exercise, weight loss, bariatric surgery and, possibly, glucose-lowering medications.

鈥淲hat we really want to avoid is for this silent disease to advance to the last stage, which is the stage of cirrhosis,鈥� Cusi said. Cirrhosis also significantly increases the risk of liver cancer.

If a patient has a higher FIB-4 score, he said, a doctor can schedule an imaging test that measures liver stiffness, which is often present in liver scarring. The patient would be referred to a liver specialist if stiffness exceeds a certain threshold.

Cusi is leading more research at the to improve MASLD early detection and find new treatments.

In the same way many track their cholesterol number, Cusi said, those at higher risk for severe MASLD-related liver disease need to know their FIB-4 number.

鈥淭he FIB-4 will help people know if they have a healthy liver or not. They should discuss the results with their doctor.鈥�