Disease of the foie gras: all concerned?

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Disease of the foie gras: all concerned?

The figures were announced at the 5th Paris NASH Meeting, last June: 1 in 5 French is affected by fatty liver disease or non-alcoholic fatty liver disease (NASH). The team of Professor Lawrence Serfaty, head of the hepatology department at the Hautepierre Hospital in Strasbourg, has been studying this pathology for years. It showed that 18.2% of the adult population (7.83 million people) would have NASH at more or less advanced stages, of which 2.6% would have severe liver disease, more than 200 000 people. at high risk of developing cirrhosis and / or liver cancer. The researchers also found that this emerging disease is twice as common in men (25.8%) as in women (11.4%) and increases with age.

A new disease?

The disease of the fatty liver is indeed a recent pathology, associated with the epidemic of obesity and diabetes (deleterious effects of sodas demonstrated), which is likely to evolve towards the cirrhosis and the cancer of the liver. Equivalent in man of the consequences of gavage in ducks or geese, it ranges from simple fatty liver (liver injury corresponding to its fat overload) to more advanced forms that are manifested by progressive attacks of the liver, inflammation in fibrosis. An illness to take very seriously because it increases the risk of cirrhosis of the liver and, subsequently, liver failure and cancer, often requiring organ transplantation. And it's not just a risk to liver health, it's often a harbinger of other diseases, such as type 2 diabetes and cardiovascular disease.

How do I know if I'm at risk or sick?

Eat a lot and move little, eat sweet or more often foods with high glycemic index (GI) (type white bread, pastries, biscuits ...), eat mainly some oils (sunflower, corn), overeat red meat and cold cuts, do without fiber, being deficient in certain vitamins (especially D) are all risk factors for gaining weight and fattening his liver. But as the symptoms are rarely marked and NASH settles silently, it is most often suspected by the doctor in view of an abnormal blood test. He prescribes an ultrasound of the liver, even an MRI. In case of a positive result, a FibroScan examination is used, which uses ultrasound to measure the elasticity of the liver: the harder the liver, the greater the fibrosis. "But in view of the increase in the number of patients, the Strasbourg hospital has set up systematic screening of patients at risk: a test called FIB 4, which is based on a mathematical formula for establishing NASH. Caregivers hope to see the generalization to make a diagnosis as early as possible "explains Serfaty.

Prevention is better than cure ?

Absolutely! Because the treatments are in the stage of development (read box). "When hepatic steatosis or early NASH are diagnosed, it is necessary to immediately reverse the "foie gras" in order to bring it back to a state of health as optimal as possible, says nutritionist Angélique Houlbert. It is possible, but it requires drastic changes in lifestyle. In addition to regular physical activity and smoking cessation, hygiene and dietary measures are implemented. " In the majority of cases, NASH is associated with obesity or abdominal obesity. It is necessary to lose weight, and sometimes strongly. For this, the NASH diet combines low calorie diets not deleterious for health: ketogenic diet low in carbohydrates and rich in good fats, low GI Mediterranean diet and low carbohydrate diet such as Atkins. It is associated with a program of physical activities in aerobic (endurance) and anaerobic (bodybuilding) to destock fat and regulate weight. A "reframing" to be conducted with the help of a professional about two months to lighten his liver and keep good habits for life!

Treatments: where is the research?

Who says emerging disease says emerging treatments. Professor Serfaty explains: "To date, about fifty new molecules are being evaluated in the treatment of NASH in more than 200 therapeutic trials around the world. Among the most advanced molecules in terms of development, four are evaluated in phase 3 trials before a possible commercialization: the obicticholic acid, the elafibranor, the selonsertib and the cenicriviroc. For the moment, only the obedticholic acid, which targets the regulation of glucido-lipid metabolism, inflammation, fibrosis, records positive results. On the other hand, the selonsertib has failed because it failed to reduce the fibrosis of patients with NASH. "

Thanks to Professor Lawrence Serfaty, President of the Paris NASH Meeting, and Angélique Houlbert, Dietician Nutritionist and author of NASH diet against fatty liver disease, ed. Thierry Souccar.

Read also :

⋙ Where does fatty liver disease come from?

⋙ Fatty liver disease: soon a test capable of detecting it

⋙ My liver does not know the crisis

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