Clinical Dilemmas in Non-Alcoholic Fatty Liver Disease

Professor Roger Williams CBE, runs the Institute of Hepatology at UCL, and is a twice former president of EASL. He has authored an incredible 2100 journal articles. Despite advancing years, he is still actively involved in clinical research -- 340 articles in the past ten years, and analysis by ISI shows him to be one of the most influential researchers in his field. The award of a CBE for services to medicine recognised his major contribution to the study of liver disorders over 25 years including leading the team who performed the first ever UK liver transplant. He also performed George Best's controversial liver transplant in 2002.Prof Williams has had many awards, medals, honorary fellowships, and in 2006 was included by HRH The Queen in a celebration at Buckingham Palace to honour those who continue to contribute to public service beyond the age of 65yrs. He was made a Fellow of King's College London in 1992 and an Honorary Fellowship from UCL was conferred on him in 2008, in recognition of his distinguished career and outstanding service to UCL.Professor Simon Taylor-Robinson joined the Department of Medicine at Imperial College London in 1997, having previously been Senior Registrar in Gastroenterology and Hepatology at Hammersmith Hospital. He was awarded the Sir Francis Avery Jones Gold Medal by the British Society of Gastroenterology in 1999 and the Young Investigator Award of the Liver Section of the European Gastroenterology Association in 1997. He is currently Director of the Imperial Clinical Research Facility at St Mary's Hospital, London.

• List of Contributors viiPreface ixPart I: Nature of the condition1 Non-alcoholic fatty liver disease: Hype or harm? 3Stephen H. Caldwell and Curtis K. Argo2 NAFLD: A worldwide problem 8Joanna K. Dowman Geoffrey C. Farrell and Philip Newsome3 Is insulin resistance the principal cause of NAFLD? 15Ian F. Godsland Sanjeev Mehta Shareen Forbes Fabian Meienberg Michael Yee Simon D. Taylor‐Robinson and Desmond G. Johnston4 Paediatric NAFLD: A distinct disease with the propensity for progressive fibrosis 29Emer Fitzpatrick and Anil Dhawan5 Non‐alcoholic fatty liver disease (NAFLD) as cause of cryptogenic cirrhosis 36Jay H. Lefkowitch6 Is NAFLD different in absence of metabolic syndrome? 44Yusuf Yilmaz7 Occurrence of noncirrhotic HCC in NAFLD 50Dawn M. Torres and Stephen A. Harrison8 Fibrosis progression: Putative mechanisms and molecular pathways 61Wing‐Kin Syn and Anna Mae Diehl9 When is it NAFLD and when is it ALD?: Can the histologic evaluation of a liver biopsy guide the clinical evaluation? 72Elizabeth M. Brunt and David E. Kleiner                                                                                                                10 Of men and microbes: Role of the intestinal microbiome in non-alcoholic fatty liver disease 82Muhammad Bilal Siddiqui Mohammed Shadab Siddiqui and Arun J. Sanyal11 Can genetic influence in non‐alcoholic fatty liver disease be ignored? 91Yang‐Lin Liu Christopher P. Day and Quentin M. Anstee12 Is there a mechanistic link between hepatic steatosis and cardiac rather than liver events? 103Soo LimPart III: Diagnosis and Scoring13 How to best diagnose NAFLD/NASH? 113Vlad Ratziu14 The clinical utility of noninvasive blood tests and elastography 124Emmanuel A. Tsochatzis and Massimo Pinzani15 Are the guidelines—AASLD IASL EASL and BSG—of help in the management of patients with NAFLD? 131Cristina Margini and Jean‐François Dufour16 Imaging methods for screening of hepatic steatosis 138Hero K. Hussain17 Are the advantages of obtaining a liver biopsy outweighed by the disadvantages? 152Jeremy F. L. Cobbold and Simon D. Taylor‐Robinson18 Screening for NAFLD in high‐risk populations 161Nader LessanPart IV: Value of treatment measures19 Defining the role of metabolic physician 173Nicholas Finer20 Should physicians be prescribing or patients self‐medicating with orlistat vitamin E vitamin D insulin sensitizers pentoxifylline or coffee? 182Haripriya Maddur and Brent A. Neuschwander‐Tetri21 Effects of treatment of NAFLD on the metabolic syndrome 189Hannele Yki‐Järvinen22 What are the dangers as well as the true benefits of bariatric surgery? 196Andrew Jenkinson23 Liver transplantation: What can it offer? 203Roger WilliamsPart V: What does the future hold?24 Molecular antagonists leptin or other hormones in supplementing environmental factors? 211Jonathan M. Hazlehurst and Jeremy W. Tomlinson25 What is the role of antifibrotic therapies in the current and future management of NAFLD? 218Natasha McDonald and Jonathan Fallowfield26 Developmental programming of non‐alcoholic fatty liver disease 226Jiawei Li Paul Cordero and Jude A. ObenIndex 232