Tags

Type your tag names separated by a space and hit enter

Management of Non-alcoholic Fatty Liver Disease and Steatohepatitis.
J Clin Exp Hepatol. 2012 Jun; 2(2):156-73.JC

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of abnormal liver enzymes and chronic liver disease in the US with expected rise in incidence paralleling the epidemic of obesity. A subset of patients with NAFLD have the progressive form of NAFLD that is termed non-alcoholic steatohepatitis (NASH), which is characterized by specific features on liver histology including hepatocellular ballooning degeneration, lobular inflammation, and zone-3 steatosis with or without peri-sinusoidal fibrosis. Non-alcoholic steatohepatitis can progress to cirrhosis and result in liver-related death. Insulin resistance is commonly seen in patients with NASH and often co-exists with other features of the metabolic syndrome including hypertension, hyperlipidemia, and obesity. Although weight loss through lifestyle modifications including dietary changes and increased physical exercise remains the backbone of management of NASH, it has proved challenging for patients to achieve and maintain weight loss goals. Thus, it is often necessary to couple lifestyle changes with another pharmacologic treatment for NASH. Insulin sensitizers including the biguanides (metformin), thiazolidinediones (pioglitazone and rosiglitazone), and glucagon-like peptide-1 receptor agonists (exenatide) are large groups of medications that have been studied for the treatment of NASH. Other agents with anti-inflammatory, anti-apoptotic, or anti-fibrotic properties which have been studied in NASH include vitamin E, pentoxifylline, betaine, and ursodeoxycholic acid. This review will provide a detailed summary on the clinical data behind the full spectrum of treatments that exist for NASH and suggest management recommendations.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA.Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25755424

Citation

Le, Thuy-Anh, and Rohit Loomba. "Management of Non-alcoholic Fatty Liver Disease and Steatohepatitis." Journal of Clinical and Experimental Hepatology, vol. 2, no. 2, 2012, pp. 156-73.
Le TA, Loomba R. Management of Non-alcoholic Fatty Liver Disease and Steatohepatitis. J Clin Exp Hepatol. 2012;2(2):156-73.
Le, T. A., & Loomba, R. (2012). Management of Non-alcoholic Fatty Liver Disease and Steatohepatitis. Journal of Clinical and Experimental Hepatology, 2(2), 156-73. https://doi.org/10.1016/S0973-6883(12)60104-2
Le TA, Loomba R. Management of Non-alcoholic Fatty Liver Disease and Steatohepatitis. J Clin Exp Hepatol. 2012;2(2):156-73. PubMed PMID: 25755424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of Non-alcoholic Fatty Liver Disease and Steatohepatitis. AU - Le,Thuy-Anh, AU - Loomba,Rohit, Y1 - 2012/07/21/ PY - 2012/04/05/received PY - 2012/05/08/accepted PY - 2015/3/11/entrez PY - 2012/6/1/pubmed PY - 2012/6/1/medline KW - ALT, alanine aminotransferase KW - AST, aspartate aminotransferase KW - Alk-phos, alkaline phosphatase KW - BMI, body mass index KW - Colesevelam KW - DEXA, dual-energy X-ray absorptiometry KW - GGT, gamma-glutamyl transferase KW - HDL, high-density lipoprotein KW - HOMA, homeostatic model assessment KW - LDL, low-density lipoprotein KW - NAFLD, non-alcoholic fatty liver disease KW - NAS, NAFLD activity score KW - NASH, non-alcoholic steatohepatitis KW - QUICKI, quantitative insulin sensitivity check index KW - S-adenosylmethionine KW - TG, triglyceride KW - exenatide KW - ezetimibe KW - metformin KW - pentoxifylline KW - statins KW - thiazolidinediones KW - ursodeoxycholic acid KW - vitamin E SP - 156 EP - 73 JF - Journal of clinical and experimental hepatology JO - J Clin Exp Hepatol VL - 2 IS - 2 N2 - Non-alcoholic fatty liver disease (NAFLD) is the most common cause of abnormal liver enzymes and chronic liver disease in the US with expected rise in incidence paralleling the epidemic of obesity. A subset of patients with NAFLD have the progressive form of NAFLD that is termed non-alcoholic steatohepatitis (NASH), which is characterized by specific features on liver histology including hepatocellular ballooning degeneration, lobular inflammation, and zone-3 steatosis with or without peri-sinusoidal fibrosis. Non-alcoholic steatohepatitis can progress to cirrhosis and result in liver-related death. Insulin resistance is commonly seen in patients with NASH and often co-exists with other features of the metabolic syndrome including hypertension, hyperlipidemia, and obesity. Although weight loss through lifestyle modifications including dietary changes and increased physical exercise remains the backbone of management of NASH, it has proved challenging for patients to achieve and maintain weight loss goals. Thus, it is often necessary to couple lifestyle changes with another pharmacologic treatment for NASH. Insulin sensitizers including the biguanides (metformin), thiazolidinediones (pioglitazone and rosiglitazone), and glucagon-like peptide-1 receptor agonists (exenatide) are large groups of medications that have been studied for the treatment of NASH. Other agents with anti-inflammatory, anti-apoptotic, or anti-fibrotic properties which have been studied in NASH include vitamin E, pentoxifylline, betaine, and ursodeoxycholic acid. This review will provide a detailed summary on the clinical data behind the full spectrum of treatments that exist for NASH and suggest management recommendations. SN - 0973-6883 UR - https://www.unboundmedicine.com/medline/citation/25755424/Management_of_Non_alcoholic_Fatty_Liver_Disease_and_Steatohepatitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0973-6883(12)60104-2 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.