People are just learning of the most deadly disease that often goes undiagnosed by doctors – UNILAD

Report on Non-Alcoholic Fatty Liver Disease (NAFLD) and Its Relevance to Sustainable Development Goals (SDGs)

Introduction

Non-Alcoholic Fatty Liver Disease (NAFLD), also known as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), is a prevalent yet often undiagnosed condition affecting nearly one-third of adults globally. Recent research highlights that approximately 15 million individuals across the US, UK, Germany, and France have NAFLD, with many unaware of their condition. This silent disease poses significant public health challenges and intersects with several Sustainable Development Goals (SDGs), particularly those related to health and well-being.

Prevalence and Diagnosis

1. A study published in The Lancet Regional Health Europe estimates around 20 million people suffer from NAFLD, but only 2.5 million have received a formal diagnosis.
2. Approximately 75% of individuals with NAFLD remain undiagnosed, underscoring the need for enhanced awareness and healthcare interventions.
3. NAFLD is typically identified during routine medical tests and can be confirmed through imaging techniques.

Understanding NAFLD

• Definition: NAFLD occurs when the liver contains more than 5% fat in individuals who consume little to no alcohol. Excessive alcohol consumption leads to a different condition known as alcohol-related fatty liver disease.
• Stages of NAFLD:
  • Simple Fatty Liver: The initial and less severe stage characterized by fat accumulation in liver cells.
  • Metabolic Dysfunction-Associated Steatohepatitis (MASH): A more serious stage involving liver inflammation due to fat build-up, potentially leading to cirrhosis and liver cancer.

Symptoms and Risk Factors

NAFLD often presents no symptoms, contributing to its underdiagnosis. When symptoms occur, they vary by disease stage:

• NAFLD Symptoms:
  • Fatigue
  • General malaise
  • Pain or discomfort in the upper right abdomen
• MASH Symptoms:
  • Itchy skin
  • Abdominal swelling
  • Shortness of breath
  • Leg swelling
  • Spider-like blood vessels under the skin
  • Enlarged spleen
  • Red palms
  • Jaundice (yellowing of skin and eyes)

Risk factors increasing susceptibility to NAFLD include:

• Obesity or overweight status
• Type 2 diabetes
• Insulin resistance-related conditions such as polycystic ovary syndrome
• Underactive thyroid
• High blood pressure
• High cholesterol
• Metabolic syndrome
• Age over 50
• Smoking

Treatment and Management

1. NAFLD is reversible, with weight loss being the primary treatment approach.
2. Clinical guidance recommends losing 10% or more of body weight; however, even a 3-5% reduction can yield health benefits.
3. Weight loss helps by:
   • Reducing liver fat
   • Lowering inflammation
   • Decreasing insulin resistance

Implications for Sustainable Development Goals (SDGs)

The management and prevention of NAFLD align closely with several SDGs, emphasizing the importance of integrated health strategies:

• SDG 3: Good Health and Well-being – Early diagnosis, awareness, and treatment of NAFLD contribute to reducing premature mortality from non-communicable diseases and promoting mental and physical health.
• SDG 2: Zero Hunger – Addressing malnutrition and promoting healthy diets can reduce obesity and metabolic disorders linked to NAFLD.
• SDG 10: Reduced Inequalities – Ensuring equitable access to healthcare services for diagnosis and treatment of NAFLD across different populations.
• SDG 12: Responsible Consumption and Production – Encouraging lifestyle changes that reduce risk factors such as unhealthy diets and smoking.
• SDG 17: Partnerships for the Goals – Collaborative research and policy-making can enhance understanding and management of NAFLD globally.

Conclusion

Non-Alcoholic Fatty Liver Disease represents a significant yet under-recognized public health issue with far-reaching consequences. Addressing NAFLD through prevention, early diagnosis, and effective treatment contributes directly to achieving multiple Sustainable Development Goals, particularly those focused on health and well-being. Increased awareness, lifestyle interventions, and healthcare system strengthening are essential to mitigate the impact of this silent disease.

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 3: Good Health and Well-being
   • The article focuses on non-alcoholic fatty liver disease (NAFLD), a significant health issue affecting millions worldwide, highlighting the need for improved health awareness, diagnosis, and treatment.
2. SDG 10: Reduced Inequalities
   • The article mentions the underdiagnosis and lack of awareness of NAFLD, implying disparities in healthcare access and information dissemination across different populations and countries.

2. Specific Targets Under Those SDGs

1. Under SDG 3: Good Health and Well-being
   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines for all.
   • Target 3.c: Substantially increase health financing and recruitment, development, training, and retention of the health workforce in developing countries.
2. Under SDG 10: Reduced Inequalities
   • Target 10.2: Empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status.

3. Indicators Mentioned or Implied to Measure Progress

1. Prevalence and Diagnosis Rates of NAFLD
   • The article provides data on the number of people affected (e.g., 15 million in US, UK, Germany, France; 20 million suffering worldwide; only 2.5 million diagnosed), which can be used as indicators to measure awareness and diagnosis coverage.
2. Mortality and Morbidity Related to NAFLD
   • Indicators related to premature mortality from liver diseases, liver cancer, and complications such as cirrhosis can measure progress towards reducing non-communicable disease burden.
3. Access to Treatment and Lifestyle Interventions
   • Indicators measuring the percentage of diagnosed patients receiving effective treatment such as weight loss programs and lifestyle modifications.
   • Measurement of health system capacity to diagnose and manage NAFLD (e.g., availability of routine tests and imaging).
4. Risk Factor Prevalence
   • Indicators tracking prevalence of obesity, type 2 diabetes, metabolic syndrome, and other risk factors mentioned in the article.

4. Table: SDGs, Targets and Indicators

Source: unilad.com