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Therapy of nonalcoholic fatty liver disease: current status.
J Physiol Pharmacol 2009; 60 Suppl 7:57-66JP

Abstract

Nonalcoholic fatty liver disease (NAFLD), the hepatic manifestation of the metabolic syndrome, has become a common entity in clinical practice. In most of the patients it presents as simple steatosis with nonprogressive clinical course. However, some patients have progressive form of NAFLD, nonalcoholic steatohepatitis (NASH), and are at increased risk of developing cirrhosis and hepatocellular carcinoma. NAFLD treatment includes lifestyle modifications and pharmacotherapy aiming at increasing insulin sensitivity, and attenuating inflammation and hepatic fibrosis. Weight reduction has consistently been shown to reduce levels of liver enzymes and insulin resistance. Although dietary intervention and exercise remain the first-line therapy, due to low patients compliance to these measures pharmacotherapy or surgical approaches are often required. Metformin and thiazolidinediones may improve insulin sensitivity, serum aminotransferase level and liver histology. However, little evidence exists regarding their sustained effects after drug discontinuation which, together with their side effects, limits their widespread use in clinical practice. Statins appear to be safe agents for the treatment of hyperlipidemia, although trials documenting their efficacy in NAFLD are scarce. Based on the recent clinical trials, weight loss medication orlistat, ursodeoxycholic acid and antioxidant agents could potentially be used as adjunctive therapy. Considering still largely controversial clinical data regarding pharmacological agents, their high cost and known side-effects, lifestyle modifications at present remain the only essential considerations in the NAFLD treatment.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Department of Medicine Sestre Milosrdnice University Hospital, Zagreb, Croatia. marko.duvnjak1@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20388946

Citation

Duvnjak, M, et al. "Therapy of Nonalcoholic Fatty Liver Disease: Current Status." Journal of Physiology and Pharmacology : an Official Journal of the Polish Physiological Society, vol. 60 Suppl 7, 2009, pp. 57-66.
Duvnjak M, Tomasic V, Gomercic M, et al. Therapy of nonalcoholic fatty liver disease: current status. J Physiol Pharmacol. 2009;60 Suppl 7:57-66.
Duvnjak, M., Tomasic, V., Gomercic, M., Smircic Duvnjak, L., Barsic, N., & Lerotic, I. (2009). Therapy of nonalcoholic fatty liver disease: current status. Journal of Physiology and Pharmacology : an Official Journal of the Polish Physiological Society, 60 Suppl 7, pp. 57-66.
Duvnjak M, et al. Therapy of Nonalcoholic Fatty Liver Disease: Current Status. J Physiol Pharmacol. 2009;60 Suppl 7:57-66. PubMed PMID: 20388946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapy of nonalcoholic fatty liver disease: current status. AU - Duvnjak,M, AU - Tomasic,V, AU - Gomercic,M, AU - Smircic Duvnjak,L, AU - Barsic,N, AU - Lerotic,I, PY - 2009/10/15/received PY - 2009/12/20/accepted PY - 2010/4/15/entrez PY - 2010/4/24/pubmed PY - 2010/8/4/medline SP - 57 EP - 66 JF - Journal of physiology and pharmacology : an official journal of the Polish Physiological Society JO - J. Physiol. Pharmacol. VL - 60 Suppl 7 N2 - Nonalcoholic fatty liver disease (NAFLD), the hepatic manifestation of the metabolic syndrome, has become a common entity in clinical practice. In most of the patients it presents as simple steatosis with nonprogressive clinical course. However, some patients have progressive form of NAFLD, nonalcoholic steatohepatitis (NASH), and are at increased risk of developing cirrhosis and hepatocellular carcinoma. NAFLD treatment includes lifestyle modifications and pharmacotherapy aiming at increasing insulin sensitivity, and attenuating inflammation and hepatic fibrosis. Weight reduction has consistently been shown to reduce levels of liver enzymes and insulin resistance. Although dietary intervention and exercise remain the first-line therapy, due to low patients compliance to these measures pharmacotherapy or surgical approaches are often required. Metformin and thiazolidinediones may improve insulin sensitivity, serum aminotransferase level and liver histology. However, little evidence exists regarding their sustained effects after drug discontinuation which, together with their side effects, limits their widespread use in clinical practice. Statins appear to be safe agents for the treatment of hyperlipidemia, although trials documenting their efficacy in NAFLD are scarce. Based on the recent clinical trials, weight loss medication orlistat, ursodeoxycholic acid and antioxidant agents could potentially be used as adjunctive therapy. Considering still largely controversial clinical data regarding pharmacological agents, their high cost and known side-effects, lifestyle modifications at present remain the only essential considerations in the NAFLD treatment. SN - 1899-1505 UR - https://www.unboundmedicine.com/medline/citation/20388946/Therapy_of_nonalcoholic_fatty_liver_disease:_current_status_ L2 - http://www.diseaseinfosearch.org/result/4280 DB - PRIME DP - Unbound Medicine ER -