PhD defence L.A. (Laurens) van Kleef

Summary:

Fatty liver disease currently affects one in three persons globally, and thereby has become the most prevalent chronic liver disease. Fortunately most people will not encounter any symptoms. However, up to 20% may develop substantial liver damage known as liver fibrosis. It is difficult to indetify those patients at risk of advanced liver disease. We demonstrated that the newly proposed name and slighly altered definition of “metabolic dsyfunction associated fatty liver disease” instead of “non-alcoholic fatty liver disease” better captures those at highest risk of liver fibrosis. Additionally we focussed on considerations in early detection of fatty liver disease. We demonstrated that the currently widely available non-invasive tests  have poor performance and should certainly not be used in elderly populations. Moreover, we demonstrated that elderly patients with fatty liver disease had similar survival as those without liver disease. This strongly indicates that early detection and treatment of fatty liver disease should focus on younger populations rather than the elderly. In another we investigated how the disease management of fatty liver disease can be improved. We found that the risk of fatty liver disease was lower among those that had more physical activity, which was measured with activity tracker watches. An important finding was that not only vigorous activity, but also moderate and light physical activity had to potential to reduce fatty liver disease risk. 
No drugs are yet available in the treatment of fatty liver disease. However, we demonstrated that statins, blood-lipid lowering drugs, may have the potential to prevent fatty liver disease and liver fibrosis in patients with dyslipidemia.