Bayesian Evidence Synthesis And Decision Modeling For Non-Alcoholic Fatty Liver Disease Essay

Obesity is an increasing issue in modern society. It has been deemed an ‘epidemic in the developed world’ and statistics (from Public Health England) show obesity in the United Kingdom has been on the rise for many years, with currently 61.9% of men and women being obese or overweight. In England alone, 1 in 4 adults (age 16 years or over) are currently obese – (25.6%) - placing more than half the adult population overweight or obese (HSE, 2014). This growing problem in developed countries is responsible for thousands of deaths each year due to a number of contributory factors.

According to the Merck Manual (2013), hyperlipidaemia is the increased synthesis of hepatic lipoproteins. Marieb (2012) explains that lipoproteins enable fat, fatty acids and cholesterol to circulate in the blood stream. They cannot do this alone due to their insolubility so they use lipoproteins as a type of transport. Nelson (2013) highlights four different varieties of lipoproteins which are chylomicrons, very low density lipoproteins (VLDL), low density lipoproteins (LDL) and high density lipoproteins (HDL).

Consequently, the result of this negative trend caused obesity to be the second leading cause of preventable deaths with 18% of American adults dying each year (CDC, 2016). According to the National Institute of Diabetes and Digestive and Kidney Diseases “more than one-third (35.7%) of adults are considered obese. More than 1 in 20 (6.3%) have extreme obesity” (NIDDK, 2012).

This case study is about Abdul Chidiac, a 51 year old male, married with 4 children. He had a medical history of hypertension, hypercholesterolaemia and cirrhosis with two admissions in the last six months. He is a smoker and drinks beer, 5-6 bottles per day. As Carithers & McClain (2010) explained the patient’s medical history is another indicator of the risk for cirrhosis; the progression to cirrhosis is adaptable and may take time over weeks or many years. Cirrhosis is a liver disease characterized by permanent scarring of the

Cirrhosis is the 12th leading cause of death in the United States. Cirrhosis affects one of the largest organs in the body, the liver. It is a condition that slowly worsens the liver and is unable to function normally due to chronic injury. Cirrhosis consists of four stages with the fourth stage being the most advanced stage of cirrhosis. When healthy liver cells are damaged and replaced by scar tissue (fibrosis) it’s known as a degenerative disease called cirrhosis. Chronic alcoholism is the leading cause of cirrhosis due to excessive drinking of alcohol, which causes the liver to swell. In sequence with alcoholism and hepatitis C, or alone obesity can be a risk factor in developing cirrhosis. Cirrhosis of the liver is a disease that can affect many individuals if the condition is not caught in early stages it can become deadly.

Over two-thirds of adults in the United States are considered overweight or obese [1]. Obesity is a significant risk factor for a number of chronic conditions, including cardiovascular disease (CVD), type 2 diabetes, and metabolic syndrome [2], [3], [4]. Metabolic syndrome is a chronic disease characterized by the presence of individual risk factors including: insulin resistance, dyslipidemia (high plasma triglycerides, low high-density lipoprotein (HDL)), hyperglycemia, and hypertension [3, 5, 6]. When evaluating the individual components of metabolic syndrome, dyslipidemia, hypertension, and insulin resistance are also considered risk factors for CVD [3]. High fat mass (FM), especially in the form of visceral fat (VF), is commonly

“Obesity-related condition include stroke, type 2 diabetes, and certain types of cancer, some the leading causes of preventable death” (Prevention Strategies & Guidelines, 2017).

Giving the fact that NAFLD is usually an asymptomatic disorder, it is often unrecognized in everyday clinical practice. Namely, most patients with NAFLD have no symptoms, and aminotransferase levels which are used as a marker of liver damage, are within normal values in almost half of all patients. NAFLD is strongly associated with type 2 diabetes mellitus (T2DM) and has been linked to increased cardiovascular disease (CVD) risk. It is characterized by insulin resistance and mitochondrial dysfunction6. Indeed, there is a gradual increase in the severity of insulin resistance in the range of NAFLD which may contribute to the evolution of liver damage. Also, it is associated with an increased risk of kidney disease in subjects with multiple CVD

Obesity is an important public health problem in the united states and the rest of the developed world. The prevalence is also increasing quickly in many developing nations worldwide. This growing incidence represents a pandemic that needs urgent attention if the potential morbidity, and economic tolls that will be left in its wake are to be avoided

Increased VLDL synthesis by the liver is caused by the production of excessive free fatty acid by various tissues. FCH is found commonly in patients suffering from the other metabolic syndrome diseases("syndrome X", incorporating hypertension, CH and central obesity, diabetes mellitus type II). After the saturation of the mechanism of converting most VLDL to LDL, the levels of VLDL elevate.

syndrome (SOS) or hepatic veno-occlusive disease (VOD) is a serious side effect was appearing in

Despite the scientific progress in the field of liver disorders, hepatic fibrosis still remains a major medical problem with significant morbidity and mortality. Liver fibrosis is a reversible response that occurs in almost all pathological conditions associated with chronic hepatic injury (Malhi and Gores 2007). After a chronic liver injury of any etiology, the damaged hepatocytes, their membrane components, metabolites of toxic agents, and infiltrating inflammatory cells activate Kupffer cells, which release a number of soluble agents, including cytokines, such as platelet-derived growth factor (PDGF), transforming growth factor-b1 (TGF-β1), tumor necrosis factor-α (TNF-α), insulin-like growth factor-1 (IGF-1) and endothelin- 1 (ET-1), as

The current epidemic of obesity is a legitimate cause for concern. It is estimated that worldwide there are 1.7 billion individuals who are overweight and that the United States has the highest percentage of overweight adults (Buchwald et al., 2004). This condition still exists despite the availability of interventions based on diet, exercise, and drug therapy. The rise in obesity has led to an increase in the prevalence of obesity-related illnesses such as Type 2 diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea (Buchwald et al., 2004) which have been associated with a decrease in overall life expectancy. The conventional therapy for Type 2 Diabetes Mellitus is weight loss (Ikramuddin et al., 2013), however, the Look AHEAD

The natural prevalence of hepatic steatosis was analyzed in the abdominal CT scans of 1,425 healthy adults and revealed that fatty infiltration occurred in 9.7%, of which 68% were diffuse, 9% being focal and solitary, and 22% being focal and multiple in distribution and the prevalence increases with age suggesting that focal patterns of hepatic steatosis are not rare mainly in older males with central

An increased amount of lifestyle variations over the recent years has led to the prevalence of a serious health condition known as Metabolic Syndrome. The major factors associated to its increase have been associated with the altered lifestyle patterns such as dietary habits, increased amount of energy-dense foods in diet and decreased physical activities. Numerous expert panels have studied the progression of this syndrome along with other associated risk factors like obesity, insulin resistance, hypertension, chronic kidney disease and cardiovascular diseases. Majorly, impaired glucose tolerance was one determining factor observed with any one of the following other factors responsible for progression of Metabolic Syndrome, which were: elevated blood pressure, low HDL-cholesterol levels, abdominal obesity and microalbuminuria. Consequently, cardiovascular disease risk