Introduction
Non-alcoholic fatty liver disease (NAFLD) is the focus of this research paper. The disorder known as NAFLD causes an accumulation of extra fat in the liver (Pouwels et al., 2022). Heavy drinking does not contribute to this fat accumulation, unlike in most cases. In contrast, alcohol-associated liver disease is the term used to describe a condition where excessive alcohol use leads to liver fat accumulation. Non-alcoholic steatohepatitis and non-alcoholic fatty liver are two kinds of NAFLD. Most people either get one type of NAFLD or the other, while occasionally, those with one form are later found to have the other type. This research aims to explore the factors impacting the development of NAFLD and the economic factors linked to this condition.
Background
NAFLD development is a complicated process anatomically, and physiologically that is still not fully understood. The pathogenesis of NAFLD and related illnesses has been the subject of much animal study in recent years, mostly to compare the effects of various dietary models on the development of this condition (Pouwels et al., 2022). It has been proposed that the development of NASH is a two-step process based on the current findings of the research studies. This process begins with the liver accumulating fat, which will make insulin resistance worse (Pouwels et al., 2022). Thus, the pathogenesis of NAFLD is linked to the accumulation of fat in the liver and the subsequent development of insulin resistance.
The second stage of this process involves cellular and molecular alterations brought on by oxidative stress and the oxidation of fatty acids in the liver. This process is a result of numerous factors, including “cytokine injury, hyperinsulinemia, hepatic iron or lipid peroxidation, variation in the extracellular matrix, altered energy homeostasis, and altered immune system function (Pouwels et al., 2022, p. 10). It takes a complex procedure for insulin resistance to develop. Increased fat mass and adipocyte differentiation are crucial factors in the emergence of insulin resistance in the context of this condition.
From the epidemiological perspective, NAFD has affected a large portion of the global population. According to Cotter and Rinella (2020), 25% of the global population has NAFD, and in the United States, 30% of the population is affected. Therefore, NAFD is a serious health concern for the global healthcare community, which requires attention to better understand its causes and effects of it on the wider population.
As with any other disease, NAFLD impacts the body systems of an individual. The liver is the main body system affected by NAFLD (Cotter & Rinella, 2020). The liver receives all the blood that exits the intestines and stomach. This blood is processed by the liver, which also breaks down, balances, and produces nutrients (Cotter & Rinella, 2020). It also metabolizes medications to make them more easily absorbed by the body or nontoxic. Thus, the liver is an essential body system, and NAFLD impairs the ability of this organ to function.
Some changes occur at the cellular level that is linked to the development of NAFLD. There have been several attempts to examine these interactions in vitro and in vivo due to the significance of cell-cell interactions for every aspect of NASH. Co-culturing cells with traditional 2D techniques or in 3D spheroids enable functional characterization of these interactions but are limited by the poor replication of the environment that governs NASH in vivo (Wallace et al., 2022). Investigations frequently focused on two subpopulations rather than the multicellular environment. These culture systems also lack flow conditions, which makes it difficult to understand extrahepatic mediators, such as dietary supplements or microbial-associated molecular patterns from the gut, adipose tissue mediators), as well as patrolling immune cells (Wallace et al., 2022). Therefore, there have been studies examining the development of NAFLD at the cellular level, which help understand this condition better.
Which chemical or biological issues are most important?
From the viewpoint of biological issues, NALF raises the question of the biological factors that impact the development of this condition. As studies by Pouwel et al. (2022) and Wallace et al. (2022), and Mazzoccoli et al. (2018), biologically, the predisposition to this condition is linked to obesity, diabetes, or insulin resistance. Therefore, this condition is a comorbidity of other chronic illnesses that affect the functioning of one’s body.
The economic issues involved in the understanding of NAFLD’s impact on the population are the cost burden that this condition places on the healthcare system. This disease is linked to metabolic symptoms and obesity, and therefore, the researcher can focus on examining some issues outside of health-related linked to this disease. In the research by Shetty and Syn (2019), the authors examined the economic burdens that patients with this condition experience. Due to the significant clinical burden and anticipated growth in the number of patients who have NAFLD over the following ten years, this condition is anticipated to have an exponential effect on the financial burden. A survey of Medicare beneficiaries with NAFLD who were hospitalized in 2010 found that the median annual total payment was approximately $11,000 per individual (Shetty & Syn, 2019). Thus, NAFLD is an economic concern both for the government providing Medicare services and for the patients receiving care.
However, one should compare the economic impact of NAFLD on patients as opposed to the payments that individuals with other conditions have to make. The study found that Medicare advantage plan holders with NAFLD had annual median outpatient care costs of $5,363, which was significantly higher than the $4,111 for the control group (Shetty & Syn, 2019). These costs were compared between patients with NAFLD and a control group with similar metabolic comorbidities. The yearly state’s economic burden is projected to increase to $103 billion from just direct medical care expenditures and to $188 billion from societal costs associated with NAFLD (Shetty & Syn, 2019). Thus, NAFLD is a serious economic concern for the population and policymakers.
The economic approach related to this issue is the question of the economic burden that patients with chronic conditions experience due to the need to receive routine medical care. As was discussed previously, Shetty and Syn (2019) report a higher amount of Medicare payments associated with this disease as opposed to other conditions. Statistical factors related to this issue also raise concerns due to the high prevalence of NAFLD. According to Pouwel et al. (2022), “NAFLD is the most common chronic liver disease in the Western world” (p. 10). Moreover, the same authors report that 30% of the United States population have this condition; NAFLD is more prevalent in people with specific diseases and conditions, including obesity and ailments like type 2 diabetes that may be connected to obesity. One-third to two-thirds of persons with type 2 diabetes are thought to have NAFLD, according to studies. NAFLD is also thought to affect up to 75% of overweight adults and more than 90% of people with extreme obesity (Pouwels et al., 2022). Therefore, apart from caring for NAFLD, many patients also have to spend money on other chronic conditions they have.
The statistical process involved in the study of NAFLD is the quantitative study that uses data from other studies to explore the main factors, statistics, and research into the topic. By doing this, the author was able to gather basic data and understand the parameters of NAFLD and its effect on the greater population. Since data from peer-reviewed studies were used, the research is based on valid information.
Conclusion
In summary, this paper focuses on NAFLD and its causes and effect on patients. An overabundance of excess fat builds up in the liver as a result of NAFLD. Unlike other situations, heavy drinking does not cause this fat to accumulate. The term “alcohol-associated liver disease” refers to a condition where excessive alcohol consumption causes liver fat to build up. Functional evaluation of the cellular effect of NAFLD is made possible by co-culturing cells using conventional 2D methods or in 3D spheroids but is constrained by the inadequate in vitro replication of the environment that controls NASH. Additionally, the lack of flow conditions in these culture systems makes it challenging to comprehend extrahepatic mediators. It is estimated that only the cost of providing direct medical care will add $103 billion to the US economy per year. In the Western world, NAFLD is the most prevalent chronic liver disease, and it affects approximately 25% of the population.
References
Cotter, T., & Rinella, M. (2020). Non-alcoholic fatty liver disease 2020: The state of the disease. Gastroenterology, 158(7), 1851-1864.
Mazzoccoli, G., De Cosmo, S., & Mazza, T. (2018). The biological clock: A pivotal hub in non-alcoholic fatty liver disease pathogenesis. Frontiers n Physiology, 9.
Pouwels, S., Sakran, N., Graham, Y., Leal, A., Pintar, T., & Yang, W. (2022). Non-alcoholic fatty liver disease (NAFLD): A review of pathophysiology, clinical management and effects of weight loss. BMC Endocrine Disorders, 22(1).
Shetty, A., & Syn, W. (2019). Health and economic burden of non-alcoholic fatty liver disease in the United States and its impact on veterans. Federal Practitioner, 36(1), 14.
Wallace, S., Tacke, F., Schwabe, R., & Henderson, N. (2022). Understanding the cellular interactome of non-alcoholic fatty liver disease. JHEP Reports, 4(8), 100524.