Tags

Type your tag names separated by a space and hit enter

NASH Therapy: omega 3 supplementation, vitamin E, insulin sensitizers and statin drugs.
Clin Mol Hepatol 2017; 23(2):103-108CM

Abstract

Non-alcoholic steatohepatitis (NASH) is the more aggressive form of non-alcoholic fatty liver disease (NAFLD). NASH can progress to hepatic fibrosis, cirrhosis, portal hypertension and primary liver cancer. Therapy is evolving with a substantial number of trials of promising new agents now in progress. In this article however, we will examine data for several older forms of therapy which have been fairly extensively studied over the years: Polyunsaturated Fatty Acid (PUFA) supplements, vitamin E, insulin sensitizing agents with a focus on pioglitazone and statin agents. Early interest in PUFA derived from their potential benefit in cardio-metabolic disease and the close association of NAFLD/NASH with Metabolic Syndrome. Results have been variable although most studies show reduction of liver fat without other major effects and their effects are influenced by concomitant weight loss and underlying genetic factors. Vitamin E has had some efficacy in pediatric NASH but questionable efficacy in even mild NASH among adults. Pioglitazone has shown significant histological benefit in a number of trials but concern over side-effects (especially weight gain) have dampened enthusiasm. A newer insulin sensitizer, liraglutide, has also shown promise in a small randomized, controlled trial. Very limited data exists regarding the histological effects of the statins in NASH and these agents appear to be fairly neutral with neither clear cut benefit nor detriment. Their use is best guided by cardiovascular risks rather than liver histology.

Authors+Show Affiliations

GI/Hepatology Division, University of Virginia, Charlottesville, Virginia, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28494529

Citation

Caldwell, Stephen. "NASH Therapy: Omega 3 Supplementation, Vitamin E, Insulin Sensitizers and Statin Drugs." Clinical and Molecular Hepatology, vol. 23, no. 2, 2017, pp. 103-108.
Caldwell S. NASH Therapy: omega 3 supplementation, vitamin E, insulin sensitizers and statin drugs. Clin Mol Hepatol. 2017;23(2):103-108.
Caldwell, S. (2017). NASH Therapy: omega 3 supplementation, vitamin E, insulin sensitizers and statin drugs. Clinical and Molecular Hepatology, 23(2), pp. 103-108. doi:10.3350/cmh.2017.0103.
Caldwell S. NASH Therapy: Omega 3 Supplementation, Vitamin E, Insulin Sensitizers and Statin Drugs. Clin Mol Hepatol. 2017;23(2):103-108. PubMed PMID: 28494529.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - NASH Therapy: omega 3 supplementation, vitamin E, insulin sensitizers and statin drugs. A1 - Caldwell,Stephen, Y1 - 2017/05/10/ PY - 2017/01/07/received PY - 2017/01/30/accepted PY - 2017/5/13/pubmed PY - 2018/4/5/medline PY - 2017/5/12/entrez KW - Fatty liver KW - Non-alcoholic fatty liver disease (NAFLD) KW - Non-alcoholic steatohepatitis (NASH) KW - Polyunsaturated Fatty Acid (PUFA) KW - Steatohepatitis SP - 103 EP - 108 JF - Clinical and molecular hepatology JO - Clin Mol Hepatol VL - 23 IS - 2 N2 - Non-alcoholic steatohepatitis (NASH) is the more aggressive form of non-alcoholic fatty liver disease (NAFLD). NASH can progress to hepatic fibrosis, cirrhosis, portal hypertension and primary liver cancer. Therapy is evolving with a substantial number of trials of promising new agents now in progress. In this article however, we will examine data for several older forms of therapy which have been fairly extensively studied over the years: Polyunsaturated Fatty Acid (PUFA) supplements, vitamin E, insulin sensitizing agents with a focus on pioglitazone and statin agents. Early interest in PUFA derived from their potential benefit in cardio-metabolic disease and the close association of NAFLD/NASH with Metabolic Syndrome. Results have been variable although most studies show reduction of liver fat without other major effects and their effects are influenced by concomitant weight loss and underlying genetic factors. Vitamin E has had some efficacy in pediatric NASH but questionable efficacy in even mild NASH among adults. Pioglitazone has shown significant histological benefit in a number of trials but concern over side-effects (especially weight gain) have dampened enthusiasm. A newer insulin sensitizer, liraglutide, has also shown promise in a small randomized, controlled trial. Very limited data exists regarding the histological effects of the statins in NASH and these agents appear to be fairly neutral with neither clear cut benefit nor detriment. Their use is best guided by cardiovascular risks rather than liver histology. SN - 2287-285X UR - https://www.unboundmedicine.com/medline/citation/28494529/NASH_Therapy:_omega_3_supplementation_vitamin_E_insulin_sensitizers_and_statin_drugs_ L2 - http://e-cmh.org/journal/view.php?doi=10.3350/cmh.2017.0103 DB - PRIME DP - Unbound Medicine ER -