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01.11.2003 | Leading Article

Advances in the Understanding and Treatment of Nonalcoholic Fatty Liver Disease

verfasst von: Stephen A. Harrison, Dr Adrian M. Di Bisceglie

Erschienen in: Drugs | Ausgabe 22/2003

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Abstract

Nonalcoholic fatty liver disease (NAFLD) is a well recognised form of chronic liver disease that has recently gained greater recognition. Originally described in the late 1950s, NAFLD is currently considered the leading cause of abnormal liver enzyme levels in the US, closely paralleling the increase in obesity and diabetes mellitus. NAFLD has a worldwide distribution, affecting both adults and children, and typically is seen in association with obesity, diabetes, hypertension and hypertriglyceridaemia. Most patients are asymptomatic and usually present with mild elevations in aminotransferases.

The natural history of NAFLD is not clearly defined but progression to cirrhosis and end-stage liver disease is well recognised in some patients. The accumulation of hepatic steatosis is thought to occur initially, primarily through hepatic and peripheral insulin resistance, which leads to altered glucose and free fatty acid metabolism. The progression from simple fatty liver to more severe forms of NAFLD (nonalcoholic steatohepatitis and cirrhosis) is much less clear but evidence suggests that oxidative stress may preferentially enhance proinflammatory cytokines, which leads to cellular adaptations and dysfunction followed by development of inflammation, necrosis and fibrosis.

Therapeutic modalities remain limited and are largely focused on correcting the underlying insulin resistance or reducing oxidative stress. However, at the present time, there are several limitations to the current potential therapies, mainly because of the lack of large-scale, prospective, randomised studies, as well as clearly defined histological endpoints. Ultimately, the future for potential therapeutic modalities to treat this disease are quite promising, but further research is needed to clearly demonstrate which therapy or therapies will be effective at eliminating fatty liver disease and its potential complications.

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Titel: Advances in the Understanding and Treatment of Nonalcoholic Fatty Liver Disease
verfasst von: Stephen A. Harrison
Dr Adrian M. Di Bisceglie
Publikationsdatum: 01.11.2003
Verlag: Springer International Publishing
Erschienen in: Drugs / Ausgabe 22/2003
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI: https://doi.org/10.2165/00003495-200363220-00001

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

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Advances in the Understanding and Treatment of Nonalcoholic Fatty Liver Disease

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Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

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Miglustat

Miglustat

Emtricitabine