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Nonalcoholic fatty liver disease: from pathogenesis to patient care.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries. It encompasses a wide spectrum of liver lesions, from pure steatosis to end-stage liver disease with cirrhosis and hepatocellular carcinoma. Nonalcoholic steatohepatitis corresponds only to one stage of NAFLD. As NAFLD can be considered a liver manifestation of the metabolic syndrome, its prevalence is high in obese people and in patients who have type 2 diabetes-insulin resistance is one of the key elements of the pathogenesis of NAFLD. This disease is often asymptomatic in the absence of decompensated cirrhosis, but should be suspected in patients with elevated aminotransferase levels or radiological evidence of a fatty liver or hepatomegaly. Liver fibrosis is associated with age over 50 years, obesity, diabetes and high triglyceride levels. Liver biopsy is the only way to assess the histologic features of necrotic inflammation and fibrosis that define nonalcoholic steatohepatitis and to determine its probable prognosis. The prognosis is good for pure steatosis, whereas the presence of necrotic inflammation is associated with a significant risk of progression to cirrhosis and, possibly, hepatocellular carcinoma. Lifestyle changes, such as dietary modifications and exercise, are recommended. To date, there have been very few randomized, placebo-controlled trials of drug treatments for NAFLD.

Authors+Show Affiliations

Assistance Publique-Hôpitaux de Paris, Department of Hepatology and Gastroenterology, Hôpital Antoine Béclère, University Paris-South 11, Clamart, France. gabriel.perlemuter@abc.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17515890

Citation

Perlemuter, Gabriel, et al. "Nonalcoholic Fatty Liver Disease: From Pathogenesis to Patient Care." Nature Clinical Practice. Endocrinology & Metabolism, vol. 3, no. 6, 2007, pp. 458-69.
Perlemuter G, Bigorgne A, Cassard-Doulcier AM, et al. Nonalcoholic fatty liver disease: from pathogenesis to patient care. Nat Clin Pract Endocrinol Metab. 2007;3(6):458-69.
Perlemuter, G., Bigorgne, A., Cassard-Doulcier, A. M., & Naveau, S. (2007). Nonalcoholic fatty liver disease: from pathogenesis to patient care. Nature Clinical Practice. Endocrinology & Metabolism, 3(6), pp. 458-69.
Perlemuter G, et al. Nonalcoholic Fatty Liver Disease: From Pathogenesis to Patient Care. Nat Clin Pract Endocrinol Metab. 2007;3(6):458-69. PubMed PMID: 17515890.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonalcoholic fatty liver disease: from pathogenesis to patient care. AU - Perlemuter,Gabriel, AU - Bigorgne,Amélie, AU - Cassard-Doulcier,Anne-Marie, AU - Naveau,Sylvie, PY - 2006/04/14/received PY - 2007/01/11/accepted PY - 2007/5/23/pubmed PY - 2007/7/20/medline PY - 2007/5/23/entrez SP - 458 EP - 69 JF - Nature clinical practice. Endocrinology & metabolism JO - Nat Clin Pract Endocrinol Metab VL - 3 IS - 6 N2 - Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries. It encompasses a wide spectrum of liver lesions, from pure steatosis to end-stage liver disease with cirrhosis and hepatocellular carcinoma. Nonalcoholic steatohepatitis corresponds only to one stage of NAFLD. As NAFLD can be considered a liver manifestation of the metabolic syndrome, its prevalence is high in obese people and in patients who have type 2 diabetes-insulin resistance is one of the key elements of the pathogenesis of NAFLD. This disease is often asymptomatic in the absence of decompensated cirrhosis, but should be suspected in patients with elevated aminotransferase levels or radiological evidence of a fatty liver or hepatomegaly. Liver fibrosis is associated with age over 50 years, obesity, diabetes and high triglyceride levels. Liver biopsy is the only way to assess the histologic features of necrotic inflammation and fibrosis that define nonalcoholic steatohepatitis and to determine its probable prognosis. The prognosis is good for pure steatosis, whereas the presence of necrotic inflammation is associated with a significant risk of progression to cirrhosis and, possibly, hepatocellular carcinoma. Lifestyle changes, such as dietary modifications and exercise, are recommended. To date, there have been very few randomized, placebo-controlled trials of drug treatments for NAFLD. SN - 1745-8374 UR - https://www.unboundmedicine.com/medline/citation/17515890/Nonalcoholic_fatty_liver_disease:_from_pathogenesis_to_patient_care_ L2 - http://dx.doi.org/10.1038/ncpendmet0505 DB - PRIME DP - Unbound Medicine ER -