Nearly a quarter of the population worldwide has nonalcoholic fatty liver disease, known as NAFLD, an umbrella term for a group of liver diseases that affect people who drink little or no alcohol. NAFLD can lead to cirrhosis, liver cancer, and liver failure.

In a new study, researchers at the University of California San Diego School of Medicine found that first-degree relatives of NAFLD patients with advanced fibrosis have a 15% risk of developing the condition.

Results published on November 1, 2022 online edition of Journal of Clinical Investigationhighlighting the importance of early screening for both siblings and offspring of patients with NAFLD.

“Until now, first-degree relatives who accompany loved ones with liver disease for medical treatment have not been known to be at greater risk of developing advanced fibrosis themselves,” said Rohit Lumba, MD, first author of the study, and professor in the department. Gastroenterology at UCSD School of Medicine and Director of Hepatology at UCSD Health.

“Liver disease is a silent killer. Most people don’t know they have a liver problem until they develop cirrhosis because there are no obvious symptoms.”

According to Loomba, study findings could play a major role in early detection.

Our goal and mission is to identify patients with the most advanced liver problems early, non-invasively, to prevent the development of cirrhosis.”

Rohit Lumba, director of the NAFLD Research Center at the University of California, San Diego School of Medicine

NAFLD is a complex metabolic disease with underlying genetic and environmental risk factors. Recent studies have shown that cirrhosis associated with NAFLD and NAFLD is hereditary, and that advanced fibrosis may cluster within the same families.

The study included nearly 400 first-degree relatives enrolled in two independent cohorts from the United States and Finland. Liver cirrhosis was evaluated using magnetic resonance elastography and other non-invasive imaging methods.

The results gave the researchers the scientific evidence needed to recommend routine screening for advanced fibrosis among first-degree relatives of patients with cirrhosis or advanced fibrosis.

“Sibs and offspring of patients should be evaluated at age 40 or 50,” Lomba said. “Our findings could change the standard of care for this high-risk population.”

Educating first-degree relatives about risk factors, including heavy drinking, being overweight and a sedentary lifestyle, is also key, Lumba added.

“Many of the genes associated with liver disease are modified based on a person’s lifestyle and what they eat. This means that first-degree relatives can help prevent advanced fibrosis if they are aware of the risks and are willing to make lifestyle modifications,” Lumba said. “Patients should be informed of their risks, because in this case they are more likely to change their behavior and lifestyle.”

Looking ahead, Lomba said the next step will be to identify genetic factors within families that increase NAFLD risk to identify and treat patients early.


University of California – San Diego

Journal reference:

Tamaki, N.; et al. (2022) Risk of advanced fibrosis in first-degree relatives of patients with nonalcoholic fatty liver disease. Journal of Clinical Investigation.

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