Topics
Metabolic diseases
Beyond Fibrosis Stratification: Integrating Behavioural, Metabolic and Policy-Level Interventions in Metabolic Dysfunction-Associated Steatotic Liver Disease
To the Editor, We read with interest the review by Vaz and colleagues [1] examining metabolic dysfunction-associated steatotic liver disease (MASLD) in Australia. They should be commended on synthesising epidemiological data and emphasising fibrosis as the principal determinant of liver-related morbidity and mortality. Their focus on fibrosis risk stratification, using the Fibrosis-4 Index followed by vibration-controlled transient elastography or enhanced liver fibrosis testing, reflects international consensus and is pragmatic and scalable given rising disease prevalence [2]....
Yousef Hakimi, Prarthana Thiagarajan, Michael Braude
Fatty Liver Disease in Australia: A Narrative Review on the Epidemiology, Natural History, Prognostication and Management in People With Metabolic Dysfunction
In Reply We thank Hakimi and colleagues [1] for their interest in our article summarising the epidemiological data pertaining to metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) in Australia [2]. We agree with their sentiments that the multisystem nature of MASLD/MAFLD necessitates a broader approach to managing metabolic health and that it is imperative for governmental policy initiatives to curb the rising prevalence and associated morbidity and mortality that occur with metabolic-associated or obesity-related diseases, which currently place a strain on resource-limited public health services....
Karl Vaz, Daniel Clayton-Chubb, William W. Kemp, Stuart K. Roberts, Ammar Majeed
When ‘Liver Enzymes’ Are Not Hepatic: Late-Onset Pompe Disease
Elevated liver function tests are commonly attributed to hepatic disease but may reflect extrahepatic pathology. We describe the case of an 18-year-old athletic woman with a 2-year history of elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK) levels, initially investigated extensively for hepatic causes. Despite normal liver imaging and biopsy, ongoing abnormalities prompted metabolic evaluation, leading to the diagnosis of late-onset Pompe disease. This case highlights the diagnostic challenges of rare metabolic myopathies, the importance of recognising muscle-derived aminotransferase elevation and the need for broad diagnostic consideration when standard investigations are unrevealing.
Shauna Madigan, Georgina England, Wayne Rankin
Fatty Liver Disease in Australia: A Narrative Review on the Epidemiology, Natural History, Prognostication and Management in People With Metabolic Dysfunction
Metabolic (dysfunction)-associated fatty liver disease (MAFLD) or metabolic (dysfunction)-associated steatotic liver disease (MASLD) is the most common and fastest growing cause of chronic liver disease worldwide. There has been a substantial increase in the epidemiological research regarding MASLD/MAFLD originating from Australia since 2020. This narrative review summarises these pivotal epidemiological studies investigating the disease prevalence, natural history, prognostication and management of this condition. The Australian literature demonstrates the prevalence to be between one-third and two-fifths of adults affected, depending on nomenclature, with a heightened risk of cardiovascular disease irrespective of terminology. Current local data support guideline-based disease staging with non-invasive tests of fibrosis and the management continues to centre on diet and lifestyle interventions, with directed therapy on the horizon.
Karl Vaz, Daniel Clayton-Chubb, William W. Kemp, Stuart K. Roberts, Ammar Majeed
The early implementation phase of the Omega‐3 Test‐and‐Treat Program for reducing the risk of preterm birth, South Australia, 2021–22: an implementation evaluation study
The program could be integrated into routine antenatal care to reduce the risk of preterm birth in Australia
Karen P Best · Celine Northcott · Lucy A Simmonds · Philippa Middleton · Lisa N Yelland · Vanessa Moffa · Khoa Lam · Penelope Coates · Cornelia Späth · Carol WK Siu · Karen Glover · Rhiannon Smith · Robert Gibson · Maria Makrides
Cause‐specific mortality among Queensland people with cirrhosis, by cirrhosis aetiology and decompensation status, 2007–22: a retrospective cohort study
Targeted public health measures for particular patient subgroups are required to save lives among people with cirrhosis
Vikas Bhasker · Jessica R Fong · Paul J Clark · Gunter F Hartel · Richard Skoien · James O’Beirne · Elizabeth E Powell · Patricia C Valery
The role of GLP‐1 receptor agonists in the management of obesity: risks and opportunities for the Australian health care system
Deshan Sebaratnam · Jessie T Lu · Helen Y Sun
Assessment of metabolic dysfunction‐associated fatty liver disease in primary care: a consensus statement summary
In recognition of the increasing burden of metabolic dysfunction-associated fatty liver disease (MAFLD) in Australia, and the lack of clear guidelines for general practitioners, this consensus statement summary presents 21 recommendations on the assessment and monitoring of MAFLD in adult patients in primary care
Leon A Adams · William W Kemp · Kate R Muller · Elizabeth E Powell · Stuart K Roberts · Luis Calzadilla Bertot · Stephanie Best · Gary Deed · Jon D Emery · Samantha L Hocking · Graham R Jones · John S Lubel · Sinead Sheils · Stephen M Twigg · Gerald F Watts · Jacob George
Hyperkalaemic cardiac arrest due to cream of tartar ingestion
A 70-year-old woman presented to the emergency department with symptomatic hyperkalaemia after excessive ingestion of potassium bitartrate to relieve constipation
Daniel Yee Lee Ng · Laksmi Govindasamy · Andrew Hughes · Hwee Min Lee
Embedding culture in co‐designed chronic disease programs for Aboriginal and Torres Strait Islander people
Aboriginal community-controlled health organisations holistically take the social determinants of health into account in service and program delivery
Rona Macniven · Karla J Canuto
Improving cardiometabolic risk factors in Aboriginal and Torres Strait Islander people in northeast Arnhem Land: single arm trial of a co‐designed dietary and lifestyle program
Culturally acceptable strategies for improving risk factors could reduce cardiometabolic disease in remote Aboriginal and Torres Strait Islander communities
Hasthi UW Dissanayake · George Gurruwiwi · J Dhurrkay · Josh C Tynan · Sabine Braat · Benjamin Harrap · Tim Trudgen · Sarah Hanieh · Bronwyn Clark · Michaela Spencer · Michael Christie · Emma Tonkin · Emily Armstrong · Leonard C Harrison · John M Wentworth · Julie K Brimblecombe · Beverley‐Ann Biggs
The role of GLP‐1 receptor agonists in the management of obesity: risks and opportunities for the Australian health care system
The use of glucagon-like peptide-1 receptor agonists in the treatment of obesity has the potential to impact one-third of Australians. This warrants due consideration and planning for future funding models, systems and models of care to ensure equitable access
Christopher Kanellis · Kyle Williams · Darcy Q Holt · Jennifer Wong · Rachel David · Ravi Carothers · Suong Le
A summary of the 2023 Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) hypertension in pregnancy guidelines
Cathy Latino · Oyekoya T Ayonrinde
Obesity in women giving birth in Victoria, 2010–2019: a retrospective cohort study
The proportion of births to Victorian women with obesity rose during 2010–2019, particularly in regional areas
Yvonne E Baker · Glyn Teale · Vidanka Vasilevski · Alemayehu Mekonnen · Linda Sweet
Phrynoderma: an under‐recognised condition reflecting nutritional deficiency
A 65-year-old man was referred to a private dermatologist for diagnosis and management of a hyperkeratotic, scaly, pruritic eruption affecting the trunk and extremities, which had been worsening over 12 months
Matthew J Verheyden · Vicki Howard · Monisha Gupta
The role of omega‐3 polyunsaturated fatty acids in the prevention of preterm birth
Affordable and accessible testing to measure omega-3 levels is paramount to reduce preterm births
Joanna YX Fu · Carol A Wang · Elyse C Mead · Jason Phung · Maria Makrides · Craig E Pennell
Is remission of type 2 diabetes mellitus real?
Remission of type 2 diabetes is achievable with a variety of management modalities, but a combination of these may be required for maintenance of remission
Stephen N Stranks · Gary A Wittert
Vitamin C insufficiency in Australia: underrated and overlooked?
A formal investigation of the vitamin C status of Australians should be undertaken
Jenny E Gunton · Nada Bechara
Serum vitamin C status of people in New South Wales: retrospective analysis of findings at a public referral hospital
Socio-economic disadvantage increases the risk of vitamin C deficiency and is a significant public health problem
Puja Bhattacharyya · Kathrin Schemann · San San Min · David R Sullivan · Stephen J Fuller
Dietary management of eosinophilic oesophagitis
Multidisciplinary models of care including dietary therapy are needed in Australia
Jessica Fitzpatrick · Sarah L Melton · Rebecca E Burgell
Current and emerging medications for the management of obesity in adults
Joshua M Inglis · Ganessan Kichenadasse · Arduino A Mangoni
Current and emerging medications for the management of obesity in adults
Rosalind Walmsley · Priya Sumithran
Current approaches in the recognition and management of eating disorders
There is emerging evidence for increased person-centred care and treatment adaptation
Phillipa J Hay · Rebekah Rankin · Lucie Ramjan · Janet Conti
Neurotoxic risks from over‐the‐counter vitamin supplements
A 40-year-old man was referred to the neuromuscular clinic with generalised fasciculations
Dhayalen Krishnan · Matthew C Kiernan
