The study highlights the importance of early screening of first-degree relatives of patients with NAFLD

The study highlights the importance of early screening of first-degree relatives of patients with NAFLD

About a quarter of the general population worldwide suffers from nonalcoholic fatty liver disease, known as NAFLD, an umbrella term for a range of liver diseases that affect people who drink little to no alcohol. NAFLD can lead to liver cirrhosis, liver cancer, and liver failure.

In a new study, researchers at the University of California San Diego School of Medicine found that first-degree relatives of patients with NAFLD, which is characterized by advanced fibrosis, have a 15 percent risk of developing the disease.

The findings, published in the November 1, 2022 online edition of the Journal of Clinical Investigation, highlight the importance of early screening of siblings and offspring of patients with NAFLD.

“Until now, first-degree relatives who accompany their loved ones with liver disease for medical treatment did not know that they were at higher risk of developing advanced fibrosis themselves,” said Dr. Rohit Loomba, lead author of the study and professor in the division of gastroenterology at UC San Diego School of Medicine and director of hepatology at UC San Diego Health.

"Liver disease is a silent killer. Most people don't know they have a liver problem until it progresses and they develop cirrhosis because there are no obvious symptoms."

According to Loomba, the results of the study could play a key role in early detection.

Our goal and mission is to identify patients with more advanced liver problems earlier and non-invasively to prevent the progression of cirrhosis.”

Rohit Loomba, director of the NAFLD Research Center at UC San Diego School of Medicine

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NAFLD is a complex metabolic disease with underlying genetic and environmental risk factors. Recent studies have shown that NAFLD and NAFLD-related liver fibrosis are hereditary and that advanced fibrosis may occur more frequently within the same families.

The study involved nearly 400 first-degree relatives enrolled in two independent cohorts from the United States and Finland. Liver fibrosis was assessed using magnetic resonance elastography and other noninvasive imaging techniques.

The results have provided researchers with the scientific evidence needed to recommend routine screening for advanced fibrosis in first-degree relatives of patients with cirrhosis or advanced fibrosis.

“Siblings and offspring of patients should be screened around age 40 or 50,” Loomba said. “Our findings could change the standard of care for this high-risk population.”

Loomba added that educating first-degree relatives about risk factors such as excessive drinking, weight gain and a sedentary lifestyle is also crucial.

"Many genes linked to liver disease change depending on a person's lifestyle and diet. This means that first-degree relatives can help prevent the development of advanced fibrosis if they are aware of the risk and willing to make lifestyle changes," Loomba said. “Patients should be informed about their risk because then they are more likely to change their behavior and lifestyle.”

Looking forward, Loomba said the next step will be to determine genetic factors within families that increase the risk of NAFLD to identify and treat patients earlier.

Source:

University of California – San Diego

Reference:

Tamaki, N., et al. (2022) Risk of advanced fibrosis in first-degree relatives of patients with nonalcoholic fatty liver disease. Journal of Clinical Investigation. doi.org/10.1172/JCI162513.

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