Lifestyle disease fatty liver in the picture

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Researchers at Maastricht UMC+ will better map this relatively unknown condition

An unhealthy lifestyle can have disastrous consequences for the liver. Fatty liver can develop, a chronic liver disease that can lead to liver failure or even liver cancer. Fatty liver also contributes to the development and worsening of diabetes and cardiovascular disease. Researchers at Maastricht UMC+ will better map this relatively unknown condition in a unique study conducted in general practices.

MDL doctor and liver specialist Ger Koek of Maastricht UMC+ is leading the research and is collaborating with Hasselt University. The research is being conducted in general practices in Maastricht (Doctors van Hier and Heer health center), Elsloo (Elsloo and Bandkeramiek medical center), Geulle GP practice and in various Belgian practices.

What is fatty liver?
Someone who does not exercise enough and eats too much unhealthy food will have to deal with an excessive supply of energy in the body. That this leads to weight gain is known to many people, but it also causes a build-up of fat in the liver. We call this fatty liver and can lead, among other things, to chronic liver inflammation with scarring. This can later develop into liver failure and liver cancer.

The flexible delivery
The liver is a flexible organ, with a large reserve capacity. As a result, fatty liver often only surface in an advanced stage, also because there are few characteristic complaints. This flexibility is also an advantage: it appears that the fatty liver can recover well if the patient makes lifestyle changes and loses at least 5% weight.

Research
Research leader Ger Koek wants to better map fatty liver: ‘More and more people with a western lifestyle are dealing with fatty liver. The problem is getting bigger and bigger, but receives less attention than other lifestyle diseases such as type 2 diabetes. It is therefore very important that we learn more about the origin and course of fatty liver.’

Goal: find patients and treat them faster
Koek and his colleagues ultimately want to study 1500 high-risk patients with conditions such as obesity, diabetes and cardiovascular disease. Their data is collected anonymously, analyzed and compared with data from other studies. Ger Koek: ‘We want to use this to identify which patients have the highest risk of developing a more serious liver disease due to fatty liver. If we succeed, we will be able to find patients faster to start treatment. That is our goal: to treat fatty liver more quickly or eventually even prevent it.’

FibroScan
The GPs in South Limburg help the researchers by approaching high-risk patients. If patients want to participate, they are given an appointment with the researchers in their own general practice. In addition to a physical examination, blood is drawn and asked to complete various questionnaires. At the end of the approximately one-hour study, the fat content and elasticity of the liver are measured with a so-called FibroScan. The decrease in elasticity is an indication of the scarring that is caused by a chronic inflammation that often proceeds without symptoms. The patients therefore do not have to come to the hospital and receive direct insight into the degree of fatty liver. Ultimately, both the patient and the GP receive a letter with the results of all tests, including the blood test, including advice.

Auto
The research materials are transported by a specially stickered car between general practices and MUMC+. This car and the stickers are sponsored by the company Loetoning from Urmond. Owner Inge Langen: ‘With this research, the researchers can map out the problems and gain more knowledge about fatty liver. We hope that with our support we can contribute to the early detection of advanced fatty liver.’

Oxygen Lever App
An App has recently been developed for patients with fatty liver to support lifestyle changes to achieve weight loss. This Happi Lever App, contains various parts such as information about fatty liver, calculation of the ideal weight, daily activities linked to eg the pedometer, how many calories are eaten and used per day. Smileys inform people how they are doing. To investigate the effect of the Happi liver App, a study is being started to achieve a 5% weight reduction in one year.

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