Non-alcoholic steatohepatitis (NASH) is on the rise in France, prompting hepatologists to sound the alarm bells. Overweight remains the first risk factor.
Foie gras is a very popular dish in France… but it also threatens the health of the population. Because ducks are not the only ones to develop fatty liver disease, and force-feeding is not the only way to achieve this. The bad eating habits of the French ended up leaving traces. Hepatologists were publicly worried about it during the Paris Hepatology Congress held at the Palais des Congrès on January 30 and 31.
12% of obese affected
NASH (non-alcoholic steatohepatitis) is increasingly common in France. So much so that it is possible to speak of a silent epidemic. Its progression in those most at risk attests to this. In 15 years, the proportion of obese affected has increased from 8 to 12%. And being overweight is the main risk factor.
This is explained by the mechanism at work: the liver stores fatty acids, which causes the destruction of liver cells. This same process greatly increases the risk of developing cirrhosis or cancer of the liver. And yet, this disease linked to overweight is still largely ignored.
The situation is all the more alarming as the number of patients with NASH is likely to increase. Indeed, a third of French people are overweight and 15% are obese. Proof of this time bomb, the share of people suffering from pure steatosis, the stage preceding NASH which reaches 15 to 20%.
No treatment available
Faced with these attacks, there is only one solution: an improvement in the hygiene of life, whether through physical activity or diet. Losing weight reduces the risk of a deleterious development. At present, no drug treatment is available, remind the specialists. It is not for lack of attempts. Metformin, omega 3, statins… all these molecules did not deliver conclusive results in the various tests.
The “drugs of the future” such as obeticholic acid, liraglutide and elafibranor are currently the subject of phase 3 clinical trials. But the conclusions are relatively disparate. Targeting the accumulation of fat in the liver, fibrosis or inflammation is not more effective. Current research projects have not shown any significant effectiveness.
While waiting for more solid studies, it is better to prevent obesity and overweight. Because the prognosis of liver cancer, the final stage of NASH, is particularly poor. Five years after diagnosis, only 10% of patients are still alive.
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