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      Genetics and epigenetics of NAFLD and NASH: Clinical impact

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      Journal of Hepatology
      Elsevier BV

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          Abstract

          Non-alcoholic fatty liver disease (NAFLD) is now recognised as the most common liver disease worldwide. It encompasses a broad spectrum of conditions, from simple steatosis, through non-alcoholic steatohepatitis, to fibrosis and ultimately cirrhosis and hepatocellular carcinoma. A hallmark of NAFLD is the substantial inter-patient variation in disease progression. NAFLD is considered a complex disease trait such that interactions between the environment and a susceptible polygenic host background determine disease phenotype and influence progression. Recent years have witnessed multiple genome-wide association and large candidate gene studies, which have enriched our understanding of the genetic basis of NAFLD. Notably, the I148M PNPLA3 variant has been identified as the major common genetic determinant of NAFLD. Variants with moderate effect size in TM6SF2, MBOAT7 and GCKR have also been shown to have a significant contribution. The premise for this review is to discuss the status of research into important genetic and epigenetic modifiers of NAFLD progression. The potential to translate the accumulating wealth of genetic data into the design of novel therapeutics and the clinical implementation of diagnostic/prognostic biomarkers will be explored. Finally, personalised medicine and the opportunities for future research and challenges in the immediate post genetics era will be illustrated and discussed.

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          Author and article information

          Journal
          Journal of Hepatology
          Journal of Hepatology
          Elsevier BV
          01688278
          February 2018
          February 2018
          : 68
          : 2
          : 268-279
          Article
          10.1016/j.jhep.2017.09.003
          29122391
          6fa65a0f-fb7c-46ae-ad92-8f0d9e8b13ef
          © 2018

          https://www.elsevier.com/tdm/userlicense/1.0/

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