Fatty Liver Disease: Fight Against ‘Silent Epidemic’ Boosted By Genetic Testing And Lifestyle Support For At-Risk Americans
The Fatty Liver Foundation (FLF) has joined forces with UK healthtech startup Sano Genetics to offer non-invasive genetic testing and community support for Americans at risk of, and living with, non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).
The partnership aims to further close the knowledge gap on hereditary risk factors with at-home DNA testing, as well as offering personalized opportunities for individuals to learn about reducing their risk through lifestyle and diet, to keep up to date with new developments in treatments and research, and to participate in medical research and clinical trials themselves.
FLF’s Screening for Undiagnosed NAFLD and NASH (SUNN) program has already screened more than 1,000 US adults who are asymptomatic and at risk from both conditions, with findings published in late 2021. The SUNN program is expanding with a goal to screen 20,000 across 20 US cities.
Sano Genetics, which combines a private-by-design technology platform and at-home testing to accelerate genetic disease research, has a strong track record of both recruiting and keeping study participants engaged and informed, having launched a number of studies into long Covid, irritable bowel disease, multiple sclerosis, Parkinson’s and Alzheimer’s.
Progress cannot come soon enough. The number of NAFLD cases among those over the age of 15 in the United States is anticipated to increase exponentially due to the growing epidemic of obesity and diabetes. By 2030, the overall prevalence of NAFLD is projected at 33.5% with NASH increasing to 27%.
And worrying new data reveals 42% of Americans reporting undesired weight gains since the start of the pandemic. Adults who put on weight gained an average 29 lbs, rising to 38 lbs among essential workers.
Fatty liver currently affects around 100 million Americans, though most don't know they have it. The current medical standards policy is not to screen for liver disease, unless people are sick and have symptoms.
Some 20 million people will go on to develop NAFLD, characterized by steatosis or infiltration of liver cells with fat, liver inflammation, liver cell injury, and fibrosis or scarring of the liver. And 5 million will progress to NASH, an advanced form of NAFLD, which is clinically significant and can lead to progressive liver fibrosis, cirrhosis, and eventually advanced liver disease, liver cancer, and death.
Despite recent scientific and medical advances, there are currently no effective pharmaceutical treatments for NAFLD. Currently, the only proven effective therapy is sustained weight loss achieved through diet and exercise or bariatric surgery. Early and comprehensive interventions, such as modifications to lifestyle and diet, can help to halt progression, preserve liver function and maintain quality of life.
In addition to the focus on early detection and screening, the SUNN program will match participants interested in clinical trials with opportunities to take part, including precision medicine trials using genetic markers such as PNPLA3.
Several research studies have shown that NAFLD/NASH may be heritable and can be influenced by many different genetic changes. Liver fibrosis has been shown to be a heritable trait, while family history can also impact the chances of developing the condition, especially if a first-degree relative has NAFLD/NASH.
Wayne Eskridge, founder and CEO of the Fatty Liver Foundation, says: “Genetic testing for NAFLD and NASH is key to improving early detection for this largely symptomless and silent epidemic. It has the potential to usher in a new era of ‘precision liver health’ that can improve our ability to provide the right liver health intervention to the right population at the right time.
“With Sano Genetics’ expertise and capabilities, we can help more people to understand their inherited risk of NAFLD/NASH, catch it earlier, and potentially treat it more effectively. Our partnership adds a whole new dimension to our SUNN program and we are excited about the opportunities for individuals and their families to support their prevention or treatment plans, as well as to facilitate opportunities for them to take part in clinical trials.”
Dr Patrick Short, co-founder and CEO of Sano Genetics, says: “Genomics is critical to early detection of this disease which often goes undiagnosed until symptoms present in the later stages. If we can locate DNA markers that indicate a predisposition in healthy or asymptomatic people, then early intervention becomes more likely. Improved understanding of genetic drivers and underlying biology of NAFLD/NASH will also pave the way for more effective targeted therapies. The FLF has been doing sterling work for many years and we’re proud to be supplying our technology and genetic testing capabilities to facilitate a proactive approach to slowing and treating fatty liver conditions.”
