MAIDEN
@MAIDEN_MAFLD
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Metabolic Dysfunction-Associated Fatty Liver Disease Consortium (MAIDEN) official account.
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A BIG thanks to this panel of esteemed leaders of our global liver community for drawing attention to the threat of
#MAFLD
and helping to save lives.
Your enthusiasm and support mean the world to us. ❤️
✅ Join our mission: ➡️ A world in which no one suffers from the
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🚨
#MAIDEN
is proud to honour women 👩⚕️ who write the history of hepatology!
👉 Thank you to these inspiring messages 📣 from esteemed leaders in the field from across the globe 🌏 as well as all of the incredible women in medicine & hepatology! 👏
#WomenInMedicine
#livertwitter
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🚨 MAFLD is the world's number 1️⃣ liver disease 🚨
✅The more people know about it, the better their chance of beating it.
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This is how your immune system chases pathogens and destroys them.
What is this process called?
#livertwitter
#medtwitter
#MAFLD
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MAFLD: a multisystem disease!
🆕 meta-analysis‼️
➡️355,886 subjects; F/U: 4.6-6.5 Y.
✅ A significant association between
#MAFLD
and the prevalence and incidence of CKD.
MAFLD needs a multidisciplinary management🤝
#MAIDEN
#livertwitter
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Most people living with
#MAFLD
can be managed in
#PrimaryCare
.
We need to raise the awareness of primary care providers on non-invasive tests & have pathways in place for when to make a referral.
📌 APASL Referral care paths for MAFLD.
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➡️ Obesity is a risk factor for all-type cancers.
🆕 meta-analysis including 24M people shows that a weight loss of >5 kg reduces overall cancer risk.
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+250 KOLs and +60 partner societies.
1️⃣ common goal.
➡️ A world in which no one suffers from the consequences of
#MAFLD
🌎🌍🌏
✅ Join our mission:
#livertwitter
#medtwitter
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📣📣
#Diabetes
care used to just be about the ABCs (HbA1c, blood pressure, cholesterol).
🚨 Now there is a 4thpillar equal to all the others:
✅ Optimizing target-organ protection (Liver, heart and kidney).
#livertwitter
#medtwitter
#MAFLD
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📣MAFLD and CKD? 🤔
🆕Study‼️
➡️6697 subjects
📌>half of subjects with
#prediabetes
presented
#MAFLD
📌MAFLD ⬆️ the age-related eGFR ⬇️.
✅The liver health assessment should be included in the conventional screening approach.
👉
#Livertwitter
#Medtwitter
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Efficacy of morning versus afternoon aerobic
#exercise
training on reducing
#metabolic
syndrome components: A randomized controlled trial👇.
#livertwitter
#medtwitter
#MAFLD
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📣📣 To protect the kidneys we need to protect the liver.
➡️
#MAFLD
is a major risk factor for kidney disease‼️
✅ It’s all about, appreciating the connection between liver and kidneys - working together!
#LiverTwitter
#MedTwitter
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➡️
#Sarcopenia
and
#MAFLD
share a bidirectional relationship.
✅ Good news‼️
➡️ Both resistance and aerobic exercise, with appropriate nutritional support, can benefit both of these conditions.
👉
#livertwitter
#medtwitter
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⏰💤 Value sleep! 7 risks of sleep deprivation:
1️⃣ Anxiety 😰
2️⃣ Depression 😔
3️⃣ Hypertension 🌡️
4️⃣ Stroke 🧠
5️⃣ Diabetes 🍩
6️⃣ Heart Disease ❤️
7️⃣ MAFLD 🤒
Prioritize sleep for well-being. 🌟💪
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🚨Identify the
#MAFLD
risk factors‼️
❌ Obesity
❌ High blood pressure
❌ High cholesterol
❌ Smoking
❌ Diabetes
❌ Unhealthy diet
❌ Family history
When we understand these ⬆️ we can better assess, control and monitor liver health.
#MAIDEN
#livertwitter
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Gut microbiota, the forgotten organ, plays key functions in the incidence of Atherosclerotic CVD.
Essential gut metabolites ( trimethylamine N-oxide, secondary bile acids, LPS, & short-chain fatty acids) have been associated w/the extent of ischemic heart diseases.
#livertwitter
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Muscle act as an endocrine organ.
Myokines have effects on glucose and lipid metabolism, cognition, fat browning, endothelial function, bone mineralization and much more...
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🔔
#MAFLD
is not a benign disease‼️
🆕 study:
➡️The outcome and survival rate of MAFLD-related HCC patients are comparable to those of HCV-related HCC patients.
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🚨
#MAFLD
in its early stages normally does not hurt 😔, but if it worsens 📈, it can cause severe liver damage, including cirrhosis.
👉Access our Multilanguage 🌍patients resources 📃to know more about the disease.
.
#MAIDEN
#LiverTwitter
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🚨 1 in 5 adults worldwide are expected to have
#obesity
by 2025.
#MAFLD
is found in over two thirds of subjects with obesity.
#LiverTwitter
#MedTwitter
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The liver is the largest solid organ in the body. Your liver is an incredibly hard-working organ with more than 500 different vital functionsincluding regulating blood levels, removing toxins, and balancing and creating nutrients for the rest of the body.
#LiverTwitter
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#Sarcopenia
and
#MAFLD
share a bidirectional relationship.
Both resistance and aerobic exercise, with appropriate nutritional support, can benefit these conditions.
#livertwitter
#medtwitter
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The Benefits of Physical Activity:
1. ⬇️ Blood Pressure
2. ⬇️ Adiposity
3. ⬇️ Inflammation
4. ⬇️ Insulin Resistance
5. ⬇️ Resting HR
6. ⬇️ Sympathetic Activity
7. ⬆️ HDL-C
8. ⬇️ LDL-C
9. ⬇️ Stress
10.⬇️ Depression
11. ⬇️ Anxiety
12. ⬇️ Fatty liver
13. ⬆️ Cognitive
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Apart from an overall caloric load, diet quality is a key determinant of metabolic dysfunction-associated fatty liver disease risk.
Low-carbohydrate diet and a low-fat diet are protective against MAFLD.
Non Alcoholic Fatty Liver Disease!
Too much fructose, sugar, or carbs can lead to non alcoholic fatty liver disease. +30%* of the US population suffers from this excessive carbohydrate consumption driven condition.
Key Drivers of Non- Alcoholic Fatty Liver Disease:
1) High
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#MAFLD
:
👉 38% prevalence in global population.
👉 Higher in patients with T2DM.
👉 Top cause of death for patients with liver disease.
❗️ Major health, social and economic burden.
📣 Be part of the movement towards a world in which no one suffers from the consequences of MAFLD.
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#MAFLD
vs
#MASLD
and the risk of hepatocellular carcinoma❓‼️
New study, 36,204 Korean participants
📌 MAFLD, but not NALFD and MASLD was found to be an independent risk factor for HCC.
#HCC
#livertwitter
#medtwitter
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12
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📌Fibrotic diseases account for nearly half of worldwide deaths.
📌 Fibrosis shares common features among tissues.
📌Could we see one day a drug that treat organ fibrosis? 🤔
#livertwitter
#medtwitter
#MAFLD
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Ultra-processed food (UPF) increases the risk of poor cardiometabolic health (high LDL cholesterol, atherosclerosis, heart attack, stroke, obesity, pre-diabetes, type 2 diabetes, MAFLD).
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Most people living with
#MAFLD
can be managed in
#PrimaryCare
.
We need to raise the awareness of primary care providers on non-invasive tests & have pathways in place for when to make a referral.
📌 APASL Referral care paths for MAFLD.
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📢
#MAFLD
vs.
#NAFLD
risk of sarcopenia and
#CVD
🆕 Study‼️
➡️ 7248 subjects, compared to non-MR NAFLD:
📌 MAFLD a/w~3.38-fold ⬆️ risk of sarcopenia.
📌 MAFLD a/w~ 3.73-fold ⬆️ risk of ASCVD.
✅ For improved prognostic value, use MAFLD!
👉
#livertwitter
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Show some love to your liver, the hardest working oragn with more than 500 different vital functions.
#livertwitter
#medtwitter
#MAFLD
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Obesity is a complex medical condition, not a moral failing.
The origins of obesity can be traced back at least 25, 000 years, as shown in the sculptures of ancient civilizations, the Greek caryatids, and Egyptian sphinxes and mummies.
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🏋️💪🏼Resistance Exercise, Ageing, Disuse, and Muscle Protein Metabolism.
👉
#livertwitter
#medtwitter
#MAFLD
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Ever wonder what high fat diet does to your liver? 🤔
Mice on high fat diet show an increase in the liver size, along with yellowish appearance as a result of steatosis that increases with time.👇
#Livertwitter
#Meddtwitter
#MAFLD
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Deeply saddened by the loss of Stephen Harrison, one of the most influential leaders in hepatology. His legacy remains with us for ever. We offer our deepest condolences to his family for their loss.
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🔔 Because
#MAFLD
symptoms are often not overt, it is often underdiagnosed and underreported, which can lead to various complications if left untreated ‼️
👉Explore its causes, symptoms, treatment options via our multi language resources
#MedTwitter
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📣📣
#Diabetes
care used to just be about the ABCs (HbA1c, blood pressure, cholesterol).
🚨 Now there is a 4thpillar equal to all the others:
✅ Optimizing target-organ protection (Liver, heart and kidney).
#livertwitter
#medtwitter
#MAFLD
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What is the single greatest risk factor for all of these diseases?
#Livertwitter
#Medtwitter
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We are excited to announce our Clinical Research Committee, led by Prof.
@battan5410
They’re providing scientific expertise and developing roadmaps that can help us reach our goals for
#MAFLD
prevention
@wong_yujun
#LiverTwitter
#MAFLD
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➡️ The liver and thyroid are intimately connected. 🤔
📌 Thyroid hormones regulate liver enzymes. When the liver is fatty, thyroid hormones don’t function properly.
📌
#Hypothyroidism
is a risk factor for incident
#MAFLD
.
✅ MAFLD requires a multidisciplinary approach.
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🔔 Fight
#MAFLD
by getting your blood pressure checked!
✅ You can do it at a doctor's office, at the pharmacy or at home with a blood pressure monitor.
#LiverTwitter
#MedTwitter
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Almost all populations consume too much sodium, which increases the risk of
#hypertension
and cardiovascular disease 🧂⚠️
Nearly 2 million deaths could be prevented each year if sodium consumption was reduced to
@WHO
recommended levels:
👨 For adults, <2000 mg/day of sodium (<5
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Root Causes of
#MAFLD
1.Physical inactivity
2.Genetic background
3.Eating unhealthy
4.Obesity
#LiverTwitter
#MedTwitter
0
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Your metabolic health influences all the other aspects of your health.
Learn what’s “good” metabolic health.
#LiverTwitter
#MedTwitter
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Inflammatory index of diet and cancer 💥
Women with a more pro inflammatory diet pattern according to the DII have a higher risk of developing cancer.
#LiverTwitter
#MedTwitter
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🚨Underappreciated reinforcing cycle:
📌 MAFLD ➡️ Sleep apnea
📌 Sleep apnea ➡️ MAFLD
✅Patients with OSA should be screened for
#MAFLD
✅ Patients with MAFLD should be considered for OSA screening
👉
#LiverTwitter
#MedTwitter
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Ever wondered why lean people are more likely to die from MAFLD compared to their non-lean counterparts?
🤔
#LiverTwitter
#medtwitter
New study shows that they have ⬆️ telomere shortening which is linked to increased mortality.
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New study Unveils role of
#Mitochondria
in dietary
#Lipid
processing
The study showed that dysfunctional mitochondria result in abnormal buildup of dietary fat within enterocytes, impeding the correct delivery of lipids to other organs.
#livertwitter
#medtwitter
#MAFLD
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More than one billion people have
#MAFLD
, which is often preventable and reversible through:
🥗 A healthy diet
🏃♀️ Regular physical activity
🚭 Not smoking
💪 Maintaining a healthy body weight
#livertwitter
#medtwitter
1
10
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🚨Identify the
#MAFLD
risk factors‼️
❌ Obesity
❌ High blood pressure
❌ High cholesterol
❌ Smoking
❌ Diabetes
❌ Unhealthy diet
❌ Family history
When we understand these ⬆️ we can better assess, control and monitor liver health.
#MAIDEN
#livertwitter
0
11
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Can hormones influence food preference? 🤔
FGF21, a hormone created in the liver in response to increased levels of sugar, acts in the brain to suppress sugar intake and controls the preference for sweet-tasting foods.
#livertwitter
#medtwitter
#MAFLD
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#KnowYourNumbers
! Checking your...
✅️ blood pressure
✅️ cholesterol levels
✅️ blood sugar levels
Checking on a regular basis is essential to help control your risk of developing
#MAFLD
!
#LiverTwitter
#MedTwitter
0
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The Benefits of Physical Activity:
1. ⬇️ Blood Pressure
2. ⬇️ Adiposity
3. ⬇️ Inflammation
4. ⬇️ Insulin Resistance
5. ⬇️ Resting HR
6. ⬇️ Sympathetic Activity
7. ⬆️ HDL-C
8. ⬇️ LDL-C
9. ⬇️ Stress
10.⬇️ Depression
11. ⬇️ Anxiety
12. ⬇️ Fatty liver
13. ⬆️ Cognitive
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Do you take care of your mitochondria?
Unhealthy mitochondria = Poor health
Mitochondrial dysfunction leads to:
• Obesity
• Fatty liver
• Diabetes
• Muscle aging
• Neurodegeneration
• Cardiovascular disease
Here are 5 ways you can improve the health of your mitochondria:
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As it hits 2000 citations🔥, a
#flashback
to one of the most influential articles that changed the Liver world.
A process:
⛓️ Robust
🌐Inclusive
💡Innovative
📌 Thousands of publications
📌 Proved utility & simplicity
📌 Non-stigmatising term
📌 Wide endorsement
Together💪& the
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🆕 global consensus of 890 international experts in various fields from 61 countries recommends that MAFLD should be coded in ICD-11.‼️
👉
#livertwitter
#medtwitter
0
8
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🔔 Because
#MAFLD
symptoms are often not overt, it is often underdiagnosed and underreported, which can lead to various complications if left untreated ‼️
👉Explore its causes, symptoms, treatment options via our simple Multilingual patients’ resources today
#MedTwitter
1
8
16
🚨Identify the
#MAFLD
risk factors‼️
❌ Obesity
❌ High blood pressure
❌ High cholesterol
❌ Smoking
❌ Diabetes
❌ Unhealthy diet
❌ Family history
When we understand these ⬆️ we can better assess, control and monitor liver health.
#MAIDEN
#livertwitter
1
10
16
📌 Bilirubin is a yellowish pigment formed during the breakdown of red blood cells, --it's what accumulates in the body with jaundice.
📌 But new data suggests that It's also a powerful anti-oxidant that appears to reduce
#obesity
,
#inflammation
, and
#insulinresistance
.
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An important joint statement by
@EuropeLiver
&
@EASOobesity
on
#MAFLD
stigma ‼️
Find out more why patients perceive “alcoholic”🍷 but not “fatty liver” as a stigmatising term.🤔
You can read the full statement
@solveigsig
@CurvyVickiM
@asscatinforma
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🚨Sarcopenia is a condition that refers to the loss of muscle mass and strength, which is more common in
#MAFLD
.
➡️ Role of concurrent "endurance and resistance" training to protect skeletal muscle mitochondrial function as an anti-sarcopenic intervention.
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#Stress
may play a major role in the development and maintenance of
#obesity
in individuals who have an increased glucocorticoid exposure or sensitivity. These insights may lead to more effective and individualized obesity treatment strategies.
#livertwitter
#medtwitter
#MAFLD
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•➡️Why do initial successful weight losses with diet and exercise seem to usually not sustain?🤔
•‼️Energy Balance! Our body compensates! It boosts appetite.
•For each kilogram of weight loss, appetite ⬆️ 100 kcal/day and our energy expenditure ⬇️ 20-30 kcal/day
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As it hits 2000 citations🔥, a
#flashback
to one of the most influential articles that changed the Liver world.
A process:
⛓️ Robust
🌐Inclusive
💡Innovative
✳️Thousands of publications
✳️Proved utility & simplicity
✳️Non-stigmatising term
✳️Endorsements
Together💪& the future🔆
1
9
16
🚨 As expensive as it is, to eat healthy food, it is even more expensive to have
#obesity
,
#MAFLD
,
#diabetes
, heart disease, cancer, or Alzheimer's disease.
✅ Make the right choices!
#LiverTwitter
#MedTwitter
0
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MAFLD vs MASLD:🤔
🆕 study; 92,177 participants with hepatic steatosis.
📌MAFLD better identifies those individuals at increased risk of major adverse cardiovascular outcome and all cause mortality.
📌The risk of MACE in MASLD+ MAFLD- population is not different from those with
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🔔🔔 MAIDEN is proud to partner with the following societies and organisations‼️
➡️We are thankful 🙏for the participation of the academic community in our endeavours, which is actually their endeavours.
➡️The time is now for us to come together 🤝 to tackle MAFLD.
#LiverTwitter
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We’re pleased to announce our official MAIDEN social media ambassadors 2023🔥🔥
👉 Discover them on & follow them for updates!
@Alboraie
@Hailem_desalegn
@drshafikuchay
@AnandVKulkarni2
@RashidLui
@drsstan
@DrMijailTapia
@mnwifi
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✅ Now published by our partner the
@MSGastroHepato
, 🇲🇾 guidance document reflects many advances 🚀 in the field pertinent to any practitioner 👩⚕️👨⚕️caring for patients with
#MAFLD
.
@WahKheong
@drsstan
@battan5410
@APichatka
👉 Explore it
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🚨 MetALD: a controversial term and concept!
Here's an updated thread on the recent articles.👇
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9
15
Have you been told you have polycystic Ovary Syndrome (PCOS)❓
📌 PCOS is highly associated with
#MAFLD
, as both diseases share common risk factors.
✅ At the time of diagnosis of PCOS, screening for MAFLD is necessary because most patients with MAFLD are asymptomatic‼️
✅ The
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Studies suggest beneficial effects for the Mediterranean diet in the prevention/management of non-communicable diseases, such as:
·
#MAFLD
· Cardiovascular diseases
· Neurodegenerative diseases
· Cancer
· Depression
· Respiratory diseases
· Fragility
#Livertwitter
#Medtwitter
1
6
15
Regular physical activity 🚴♀️🏃♂️🏋️♀️🕺 helps prevent and treat:
❌ MAFLD
❌ Heart disease
❌ Stroke
❌ Diabetes
❌ Hypertension
❌ Overweight and obesity
✅ Every move counts!
#LiverTwitter
#MedTwitter
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Exercise-Induced Changes in Visceral Adipose Tissue Mass (VATM)
✅Exercise reduces VATM
✅Loss of VATM following exercise is dependent on IL-6
✅Improvements in cardiorespiratory fitness following exercise are not IL-6 dependent.
👉
#MAFLD
#Livertwitter
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🔔🔔Metabolic diseases like
#MAFLD
,
#hypertension
,
#diabetes
and
#obesity
:
➡️Are killer ☠️
➡️Create disability
➡️Contribute to soaring healthcare costs 💵
‼️The good news? 😀
✅Reversing these health issues is possible via Healthy Diet 🍽️ & Exercise 🚴 . Make the right
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Coffee ☕️and
#MAFLD
:
✅⬇️risk of MAFLD
✅⬇️risk of cirrhosis
✅⬇️risk of HCC
Drink your coffee! ☕
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⏰ Don't miss out on the latest science from the 33rd Scientific Sessions of the APASL annual meeting!
✅Discover key insights on liver disease and
#MAFLD
management for better patient outcomes.
Early bird registration is now open!
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�� Metabolic dysfunction-associated fatty liver disease (
#MAFLD
) and Sarcopenia additively increase mortality.
❌ Sarcopenia: no consensus, no diagnostic criteria, and no approved indication—How did we get here?
👉
#livertwitter
#medtwitter
0
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Evidence suggests that MAFLD can still progress or develop de novo hepatocellular carcinoma in treated patients with HCV.
Here is, a parctical algorithm by an international expert panel for the integration of MAFLD in the screening approach for SVR patients👇.
#livertwitter
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📣📣 Have you been told you have polycystic Ovary Syndrome (PCOS)❓
📌 PCOS is one of the most common endocrine disorders in women.
📌 PCOS is highly associated with
#MAFLD
as both diseases share common risk factors.
✅ At the time of diagnosis of PCOS, screening for MAFLD is
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🆕 viewpoint:
#NAFLD
-
#MASLD
-
#MAFLD
continuum: a swinging pendulum?
#livertwitter
, any thoughts? 🤔
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🚨 You SHOULD aim to be in the normal BMI range.
But that is merely the starting point and the KEY target 🎯 is to be metabolically healthy.
Look after your metabolic health:
🥗 Eat a variety of food including fruit & vegetables
💧 Drink lots of water
☕️Drink coffee
🧂 Cut back
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🚨 Replacing sugars with sugar-sweetened may reduce caloric intake, but increase risk of HCC & death from chronic liver diseases!
👉
#LiverTwitter
#MedTwitter
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15
➡️ Cannabis use is associated with:
📌 ⬇️ risk of MAFLD
📌 ⬇️ BMI
📌 ⬇️ risk of liver fibrosis
‼️ Could cannabis offer a treatment option for
#MAFLD
?
#livertwitter
#medtwitter
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Did you know that air pollution has a positive correlation with MAFLD (Metabolic dysfunction-associated fatty liver disease).
PM2.5 pollutants have an OR of 1.49 u/ MAFLD. Men who smoke + eat a lot of fat have a higher risk.
Lifestyle is not only food but also the air you
1
7
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As it exceeded 2500 citations🔥, a
#flashback
to one of the most influential articles that changed the Liver world.
A process:
⛓️ Robust
🌐Inclusive
💡Innovative
📌 Thousands of publications
📌 Proved utility & simplicity
📌 Non-stigmatising term
📌 Wide endorsement
Together💪&
3
8
14
