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Recent concepts in non-alcoholic fatty liver disease.
Diabet Med. 2005 Sep; 22(9):1129-33.DM

Abstract

Non-alcoholic fatty liver disease (NAFLD) is present in up to one-third of the general population and in the majority of patients with metabolic risk factors such as obesity and diabetes. Insulin resistance is a key pathogenic factor resulting in hepatic fat accumulation. Recent evidence demonstrates NAFLD in turn exacerbates hepatic insulin resistance and often precedes glucose intolerance. Once hepatic steatosis is established, other factors, including oxidative stress, mitochondrial dysfunction, gut-derived lipopolysaccharide and adipocytokines, may promote hepatocellular damage, inflammation and progressive liver disease. Confirmation of the diagnosis of NAFLD can usually be achieved by imaging studies, however, staging the disease requires a liver biopsy. NAFLD is associated with an increased risk of all-cause death, probably because of complications of insulin resistance such as vascular disease, as well as cirrhosis and hepatocellular carcinoma, which occur in a minority of patients. NAFLD is also now recognized to account for a substantial proportion of patients previously diagnosed with 'cryptogenic cirrhosis'. Diabetes, obesity and the necroinflammatory form of NAFLD known as non-alcoholic steatohepatitis, are risk factors for progressive liver disease. Current treatment relies on weight loss and exercise, although various insulin-sensitizing medications appear promising. Further research is needed to identify which patients will achieve the most benefit from therapy.

Authors+Show Affiliations

Department of Medicine and Pharmacology, The University of Western Australia, Perth, Australia.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

16108837

Citation

Adams, L A., and P Angulo. "Recent Concepts in Non-alcoholic Fatty Liver Disease." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 22, no. 9, 2005, pp. 1129-33.
Adams LA, Angulo P. Recent concepts in non-alcoholic fatty liver disease. Diabet Med. 2005;22(9):1129-33.
Adams, L. A., & Angulo, P. (2005). Recent concepts in non-alcoholic fatty liver disease. Diabetic Medicine : a Journal of the British Diabetic Association, 22(9), 1129-33.
Adams LA, Angulo P. Recent Concepts in Non-alcoholic Fatty Liver Disease. Diabet Med. 2005;22(9):1129-33. PubMed PMID: 16108837.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recent concepts in non-alcoholic fatty liver disease. AU - Adams,L A, AU - Angulo,P, PY - 2005/8/20/pubmed PY - 2005/12/20/medline PY - 2005/8/20/entrez SP - 1129 EP - 33 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 22 IS - 9 N2 - Non-alcoholic fatty liver disease (NAFLD) is present in up to one-third of the general population and in the majority of patients with metabolic risk factors such as obesity and diabetes. Insulin resistance is a key pathogenic factor resulting in hepatic fat accumulation. Recent evidence demonstrates NAFLD in turn exacerbates hepatic insulin resistance and often precedes glucose intolerance. Once hepatic steatosis is established, other factors, including oxidative stress, mitochondrial dysfunction, gut-derived lipopolysaccharide and adipocytokines, may promote hepatocellular damage, inflammation and progressive liver disease. Confirmation of the diagnosis of NAFLD can usually be achieved by imaging studies, however, staging the disease requires a liver biopsy. NAFLD is associated with an increased risk of all-cause death, probably because of complications of insulin resistance such as vascular disease, as well as cirrhosis and hepatocellular carcinoma, which occur in a minority of patients. NAFLD is also now recognized to account for a substantial proportion of patients previously diagnosed with 'cryptogenic cirrhosis'. Diabetes, obesity and the necroinflammatory form of NAFLD known as non-alcoholic steatohepatitis, are risk factors for progressive liver disease. Current treatment relies on weight loss and exercise, although various insulin-sensitizing medications appear promising. Further research is needed to identify which patients will achieve the most benefit from therapy. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/16108837/Recent_concepts_in_non_alcoholic_fatty_liver_disease_ L2 - https://doi.org/10.1111/j.1464-5491.2005.01748.x DB - PRIME DP - Unbound Medicine ER -