NAFLD entails an increased risk of liver-related events associated with cirrhosis, such as ascites, esophageal varices, hepatic encephalopathy, and hepatocellular carcinoma (HCC). Even though NAFLD progresses slowly (over decades), and only circa 5% develop cirrhosis, it is now the leading cause of HCC and the second leading etiology for liver transplantation.
The gold standard for diagnosing and staging chronic liver diseases is by histopathological evaluation, which requires a liver biopsy. However, recently, novel biomarkers such as magnetic resonance (MR) imaging, has shown promise in replacing liver biopsy for quantification and evaluation of hepatic fat accumulation and fibrosis, portal blood flow, body composition and sarcopenia.
Currently, the most validated non-invasive biomarkers are easily available blood-based scores, advanced MR exams and vibration controlled transient elastography (e.g., Fibroscan®). However, several new biomarkers are under investigation, with experimental blood- and gene-based analyses, radiological techniques, and cytokines being thoroughly evaluated. Moreover, body composition, sarcopenia, and structural heart changes have shown an intricate relationship associated with cardiovascular and liver-related outcome in individuals with chronic liver diseases.
The relationship between body composition, sarcopenia and chronic liver diseases is poorly understood. However, sarcopenia seems to be associated with a more dismal prognosis in patients with chronic liver diseases, and especially liver cirrhosis.
The main purpose of our projects is to untangle the relationship between chronic liver disease, body composition and sarcopenia, and its relevance for diagnosis, prognosis, and treatment. Furthermore, we aim to define clinically relevant risk phenotypes amongst individuals with chronic liver diseases, and especially non-alcoholic fatty liver disease.