MAFLD screening in real practice in Slovakia: the SIRIUS study

Česká verzia

Authors: Mária Szántová ¹; Tomáš Koller ²; Marek Rác ³; Svetlana Adamcová-Selčanová ⁶; Xénia Faktorová ⁴; Martina Jakabovičová ¹; Zuzana Urkovičová ¹; Viliam Mojto ¹; Peter Jarčuška ⁵; Martin Janíčko ⁵; Ubomír Skladaný ⁶
Authors place of work: III. interná klinika LF UK a UNB, Nemocnica akademika Ladislava Dérera, Bratislava ¹; V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava ²; Interná klinika FN Nitra ³; Interné oddelenie – klinika SZU a Univerzitná nemocnica – Nemocnica svätého Michala, a. s., Bratislava ⁴; II. interná klinika LF UPJŠ a UNLP, Košice ⁵; II. interná klinika SZU a FNsP F. D. Roosevelta, Banská Bystrica ⁶
Published in the journal: Diab Obez 2022; 22(44): 109-124
Category: Clinical studies

Summary

The global pandemic of obesity, metabolic syndrome and its manifestations are responsible for the rapidly increasing incidence of Metabolic Associated Fatty Liver Disease (MAFLD), liver cirrhosis and hepatocellular carcinoma. MAFLD is a redefinition of the previously used term NAFLD (Non-Alcoholic Fatty Liver Disease). Slovakia’s position at the top of the European and world rankings of preventable liver mortality and morbidity is a wake-up call for the whole society. Alarming statistics led hepatologists under the auspices of the Slovak Hepatological Society to initiate the SIRIUS project, which is a liver disease screening program for people without known liver disease. The article discusses the main background, aims and objectives of the project and its practical implementation in two branches – community and outpatient. The main goal is to awaken the sleeping Slovakia from a state of passivity and inactivity to active dedistribution, education, screening and prevention of liver diseases at all levels to return to a healthy way of life. Every citizen and every medical practitioner can become a participant of the project. The outpatient arm of the project is conducted online, without the need for pre-registration via – SIRIUS. Non-invasive Fib4 fibrosis index, NFS (NAFLD Fibrosis Score) and Fibroscan liver elasticity testing are the main tools for detection of severe fibrosis.

Keywords:

screening – liver fibrosis – MAFLD

Zdroje

1. Eslam M, Newsome PN, Sarin SK et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol 2020; 73(1): 202–209. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2020.03.039>.

2. Yamamura S, Eslam M, Kawaguchi T et al. MAFLD identifies patients with significant hepatic fibrosis better than NAFLD. Liver Int 2020; 40(12): 3018–3030. Dostupné z DOI: <https://doi.org/10.1111/liv.14675>.

3. Fouad Y, Dufour JF, Zheng MH et al. The NAFLD-MAFLD debate: Is there a Consensus on Consensus methodology? Liver Int 2022; 42(4): 742–748. Dostupné z DOI: <http://dx.doi.org/10.1111/liv.15197>.

4. Kim D, Konyn P, Sandhu KK et al. Metabolic dysfunction-associated fatty liver disease is associated with increased all-cause mortality in the United States. J Hepatol 2021; 75(6): 1284–1291. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2021.07.035>.

5. Younossi ZM, Henry L. Epidemiology of non-alcoholic fatty liver disease and hepatocellular carcinoma. JHEP Rep 2021; 3(4): 100305. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhepr.2021.100305>.

6. Younossi ZM, Koenig AB, Abdelatif D et al. Global Epidemiology of Nonalcoholic Fatty Liver Disease – Meta-Analytic Assessment of Prevalence, Incidence and Outcomes. Hepatology 2016; 64(1): 73–84. Dostupné z DOI: <http://dx.doi.org/10.1002/hep.28431>.

7. Karlsen TH, Sheron N, Zelber-Sagi S et al. The EASL–Lancet Commission: protecting the next generation of Europeans against liver disease complications and premature mortality. Lancet 2022; 399(10319): 61–116. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(21)01701–3>.

8. Mokáň M, Galajda P, Martinka E et al. Odporúčania pre prevenciu diabetes mellitus 2. typu. Štandardný postup MZdSR č. 028, 1.10.2021. Dostupné z WWW: <https://www.health.gov.sk/?Postupy-Prevencia>.

9. Madarasová -Gecková A, Bakalár P, Baška T et al. HBSC- Slovensko-2017/2018. Národná správa o zdraví a so zdravím súvisiacom správaní 11, 13 a 15-ročných školákov na základe prieskumu uskutočneného v roku 2017/2018 v rámci medzinárodného projektu „Health-Behaviour in School-aged Children“ 2019. ÚVZ SR. ISBN 978–80–7159–242–6.

10. Cholongitas E, Pavlopoulou I, Papatheodoridi M et al. Epidemiology of nonalcoholic fatty liver disease in Europe: a systematic review and meta-analysis. Ann Gastroenterol 2021; 34(3): 404–414. <http://dx.doi.org/10.20524/aog.2021.0604>.

11. Lazarus JV, Ekstedt M, Marchesini G et al. A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe. J Hepatol 2020; 72(1): 1: 14–24. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2019.08.027>.

12. Dyba T, Randi G, Bray F et al. The European cancer burden in 2020: Incidence and mortality estimates for 40 countries and 25 major cancers. Eur J Cancer 2021; 157: 308–347. <http://dx.doi.org/10.1016/j.ejca.2021.07.039>.

13. Informácie dostupné z WWW: https://canceratlas.cancer.org/the-burden/europe.

14. Myers S, Neyroud-Caspar I, Spahr L et al. NAFLD and MAFLD as emerging causes of HCC: A populational study. J HEP Rep 2021; 19(3): 100231. Dostupné z DOI: <http://doi: 10.1016/j.jhepr.2021.100231>.

15. United States Cancer Statistics (USCS). Dostupné z WWW: <https://www.cdc.gov/cancer/dataviz/>.

16. CDC. United States Cancer Statistics. Annual Number of New Cancers, 1999–2019. Dostupné z WWW: <https://gis.cdc.gov/Cancer/USCS/#/Trends/>.

17. Berg T, Buti M. Liver Cancer: Europe´s Public Health Ticking Time Bomb. Dostupné z WWW: <https://healthpolicy-watch.news/liver-cancer-europe/>.

18. Finger JD, Hoebel J, Kuntz B. et al. Educational differences in the prevalence of behavioural risk factors in Germany and the EU- Results from the European Health Interview Survey (EHIS)2. J Health Monit 2019; 4(499: 29–47. Dostupné z DOI: <http://dx.doi.org/10.25646/6225>.

19. Szántová M, Skladaný Ľ, Janičko M et al. Questionnaire for risk factors of alcoholic and nonalcoholic fatty liver disease. Bratisl Med J 2022; 123(7): 496–504. Dostupné z DOI: <http://dx.doi.org/10.4149/BLL_2022_079>.

20. Eurostat: Sustainable development in the European Union. Monitoring report on progress towards the SDGs in an EU context. 2022 edition. 6th ed. EU. ISBN 978–92–76–46574–4 .Dostupné z DOI: <http://dx.doi.org/10.2785/632786>.

21. Boursier J, Hagstrom H, Ekstedt M et al. Non-invasive tests acurately stratify patients with NAFLD based on their risk of liver-related events. Journal of Hepatology 2022; 76(5): 1013–1020. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2021.12.031>.

22. Szántová M, Jakabovičová M. Riziká kontaminácie výživových doplnkov s obsahom silymarínu. Súč Klin Pr 2022; 2: 39–44.

23. Newsome PN, Buchholtz K, Cusi K et al. A placebo – controlled trial of subcutaneous Semaglutide in nonalcoholic steatohepatitis. N Engl J Med 2021; 384(12): 1113–1124. Dostupné z DOI: <https://doi.org/10.1056/NEJMoa2028395>.

24. 24. Blum K. NASH Dash: The Pipeline Race is on for New Agents. Pharmacy Practice News. 2022. Dostupné z www: <https://www.pharmacypracticenews.com>.

25. Francque SM, Marchesini G, Kautz A et al. Non-alcoholic fatty liver disease: A patient guideline. JHEP Rep 2021; 3(5): 100322. Dostupné z DOI: <https://doi.org/10.1016/j.jhepr.2021.100322>.

26. Rác M. Diabezita a ochorenia pečene. Via Pract 2021; 18(2): 54–60.

27. Belovičová M. Dieta u jaterních onemocnění. Forsapi 2015. ISBN 978–80–87250–26–6. EAN: 9788087250266.

28. Szántová M, Belovičová M. Alkohol – manuál rizík, skríningu a intervencie. Worwag Pharma: Bardejov 2021. ISBN 9788097146092.

29. Fathi A. Odvrátiteľné riziká chorôb obehovej sústavy. Infodoktor: Štrba 2020. ISBN 9788097366001.

30. Minárik P, Rác M, Blaho E. Diéta pri ochoreniach pečene. Raabe: Bratislava 2019. ISBN: 9788081404023.