Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Die Folgen des Klimwandels haben einen direkten Einfluss auf die Primärversorgung in Deutschland: Hitzeschutz insbesondere bei älteren Patienten, die Zunahme von Infektionen und die Verlängerung der Allergiesesaison spielen medizinisch eine bedeutsame Rolle. Aber auch in der Prävention und der Aufklärung der Patienten kommt den Hausärztinnen und -ärzten eine besondere Rolle zu. Direkt aus der Praxis berichtet im Live-Webinar am 13. Mai von 18 bis 19 Uhr unser Experte Dr. med. Robin Maitra.
Erweiterte Suche
Anmelden
nach oben
Current Hepatology Reports
Erschienen in: Current Hepatology Reports 4/2020

09.09.2020 | Fatty Liver Disease (D Halegoua-DeMarzio, Section Editor)

Exercise as Medicine: The Impact of Exercise Training on Nonalcoholic Fatty Liver Disease

verfasst von: Audrey Thorp, Jonathan G. Stine

Erschienen in: Current Hepatology Reports | Ausgabe 4/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Nonalcoholic fatty liver disease (NAFLD) is a leading cause of global liver disease. Because current pharmacologic treatments are ineffective, lifestyle change centered on exercise remains the most effective NAFLD treatment. The aim of this systematic review is to summarize and evaluate the current evidence supporting the use of exercise training as a medical treatment for adult patients with NAFLD.

Recent Findings

At least 150 min each week of moderate intensity exercise of any type can improve NAFLD, both with and without modest weight loss. Exercise training reduces hepatic steatosis and liver inflammation, favorably changes body composition, improves vascular endothelial function, increases cardiorespiratory fitness, and can lead to histologic response. To date, exercise-based NAFLD trials are limited by small sample size and significant heterogeneity.

Summary

While several key questions remain unanswered, exercise training will always be an important part of the medical management of patients with NAFLD.
Literatur
1.
Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.PubMed
2.
Sanyal AJ, Brunt EM, Kleiner DE, Kowdley KV, Chalasani N, Lavine JE, et al. Endpoints and clinical trial design for nonalcoholic steatohepatitis. Hepatology. 2011;54(1):344–53.PubMedPubMedCentral
3.
Ludwig J, Viggiano TR, McGill D, Oh BJ. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc. 1980;55(7):434–8.PubMed
4.
Lam B, Kurzke K, Younossi Z. The clinical and economic burden of nonalcoholic steatohepatitis. Curr Hepatol Rep. 2018;17(4):345–9.
5.
• Croci I, Coombes JS, Bucher Sandbakk S, Keating SE, Nauman J, Macdonald GA, et al. Non-alcoholic fatty liver disease: prevalence and all-cause mortality according to sedentary behaviour and cardiorespiratory fitness. The HUNT Study. Prog Cardiovasc Dis. 2019;62(2):127–34.PubMed
6.
Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328–57.PubMed
7.
• Mazzotti A, Caletti MT, Brodosi L, di Domizio S, Forchielli ML, Petta S, et al. An internet-based approach for lifestyle changes in patients with NAFLD: two-year effects on weight loss and surrogate markers. J Hepatol. 2018;69(5):1155–63.PubMed
8.
Musso G, Gambino R, Cassader M, Pagano G. A meta-analysis of randomized trials for the treatment of nonalcoholic fatty liver disease. Hepatology. 2010;52(1):79–104.PubMed
9.
Sullivan S, Kirk EP, Mittendorfer B, Patterson BW, Klein S. Randomized trial of exercise effect on intrahepatic triglyceride content and lipid kinetics in nonalcoholic fatty liver disease. Hepatology. 2012;55(6):1738–45.PubMedPubMedCentral
10.
Physical Activity Guidelines for Americans, U.S.D.o.H.a.H. Services, Editor. 2018, U.S Department of Health and Human Services: Washington, DC.
11.
Kim D, et al. Physical activity, measured objectively, is associated with lower mortality in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol.
12.
13.
American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41(3):687–708.
14.
Saeed N, et al. Evaluation of dietary approaches for the treatment of non-alcoholic fatty liver disease: a systematic review. Nutrients. 2019;11(12).
15.
Ryan MC, Itsiopoulos C, Thodis T, Ward G, Trost N, Hofferberth S, et al. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol. 2013;59(1):138–43.PubMed
16.
Misciagna G, del Pilar Díaz M, Caramia DV, Bonfiglio C, Franco I, Noviello MR, et al. Effect of a low glycemic index Mediterranean diet on non-alcoholic fatty liver disease. A randomized controlled clinical trial. J Nutr Health Aging. 2017;21(4):404–12.PubMed
17.
Katsagoni CN, Papatheodoridis GV, Ioannidou P, Deutsch M, Alexopoulou A, Papadopoulos N, et al. Improvements in clinical characteristics of patients with non-alcoholic fatty liver disease, after an intervention based on the Mediterranean lifestyle: a randomised controlled clinical trial. Br J Nutr. 2018;120(2):164–75.PubMed
18.
Abenavoli L, et al. Effect of Mediterranean diet and antioxidant formulation in non-alcoholic fatty liver disease: a randomized study. Nutrients. 2017;9(8).
19.
Properzi C, O'Sullivan TA, Sherriff JL, Ching HL, Jeffrey GP, Buckley RF, et al. Ad libitum Mediterranean and low-fat diets both significantly reduce hepatic Steatosis: a randomized controlled trial. Hepatology. 2018;68(5):1741–54.PubMed
20.
Johari MI, Yusoff K, Haron J, Nadarajan C, Ibrahim KN, Wong MS, et al. A randomised controlled trial on the effectiveness and adherence of modified alternate-day calorie restriction in improving activity of non-alcoholic fatty liver disease. Sci Rep. 2019;9(1):11232.PubMedPubMedCentral
21.
Yamamoto M, Iwasa M, Iwata K, Kaito M, Sugimoto R, Urawa N, et al. Restriction of dietary calories, fat and iron improves non-alcoholic fatty liver disease. J Gastroenterol Hepatol. 2007;22(4):498–503.PubMed
22.
•• Katsagoni CN, Georgoulis M, Papatheodoridis GV, Panagiotakos DB, Kontogianni MD. Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: a meta-analysis. Metabolism. 2017;68:119–32.PubMed
23.
Kaminsky LA, Arena R, Myers J. Reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: data from the Fitness Registry and the Importance of Exercise National Database. Mayo Clin Proc. 2015;90(11):1515–23.PubMedPubMedCentral
24.
Williams PT. Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med Sci Sports Exerc. 2001;33(5):754–61.PubMedPubMedCentral
25.
Clausen JSR, Marott JL, Holtermann A, Gyntelberg F, Jensen MT. Midlife cardiorespiratory fitness and the long-term risk of mortality. J Am Coll Cardiol. 2018;72(9):987–95.PubMed
26.
Strasser B, Burtscher M. Survival of the fittest: VO(2)max, a key predictor of longevity? Front Biosci (Landmark Ed). 2018;23:1505–16.
27.
Aspenes ST, et al. Peak oxygen uptake and cardiovascular risk factors in 4631 healthy women and men. Med Sci Sports Exerc. 2011;43(8):1465–73.PubMed
28.
Sayiner M, Stepanova M, Pham H, Noor B, Walters M, Younossi ZM. Assessment of health utilities and quality of life in patients with non-alcoholic fatty liver disease. BMJ Open Gastroenterol. 2016;3(1):e000106.PubMedPubMedCentral
29.
• Argo CK, Stine JG, Henry ZH, Lackner C, Patrie JT, Weltman AL, et al. Physical deconditioning is the common denominator in both obese and overweight subjects with nonalcoholic steatohepatitis. Aliment Pharmacol Ther. 2018;48(3):290–9.PubMedPubMedCentral
30.
Austin P, Gerber L, Paik JM, Price JK, Escheik C, Younossi ZM. Aerobic capacity and exercise performance in nonalcoholic fatty liver disease. J Sports Med Phys Fitness. 2019;59(8):1376–88.PubMed
31.
Kantartzis K, Thamer C, Peter A, Machann J, Schick F, Schraml C, et al. High cardiorespiratory fitness is an independent predictor of the reduction in liver fat during a lifestyle intervention in non-alcoholic fatty liver disease. Gut. 2009;58(9):1281–8.PubMed
32.
Pugh CJ, et al. Exercise-induced improvements in liver fat and endothelial function are not sustained 12 months following cessation of exercise supervision in nonalcoholic fatty liver disease. Int J Obes. 2016;40(12):1927–30.
33.
34.
Giby VG, Ajith TA. Role of adipokines and peroxisome proliferator-activated receptors in nonalcoholic fatty liver disease. World J Hepatol. 2014;6(8):570–9.PubMedPubMedCentral
35.
Hashida R, Kawaguchi T, Bekki M, Omoto M, Matsuse H, Nago T, et al. Aerobic vs. resistance exercise in non-alcoholic fatty liver disease: a systematic review. J Hepatol. 2017;66(1):142–52.PubMed
36.
Yang X, Smith U. Adipose tissue distribution and risk of metabolic disease: does thiazolidinedione-induced adipose tissue redistribution provide a clue to the answer? Diabetologia. 2007;50(6):1127–39.PubMed
37.
Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev. 2000;21(6):697–738.PubMed
38.
Stine JG, Xu D, Schmitz K, Sciamanna C, Kimball SR. Exercise attenuates ribosomal protein six phosphorylation in fatty liver disease. Dig Dis Sci. 2020.
39.
Richter EA, Ruderman NB. AMPK and the biochemistry of exercise: implications for human health and disease. Biochem J. 2009;418(2):261–75.PubMedPubMedCentral
40.
Apró W, Wang L, Pontén M, Blomstrand E, Sahlin K. Resistance exercise induced mTORC1 signaling is not impaired by subsequent endurance exercise in human skeletal muscle. Am J Physiol Endocrinol Metab. 2013;305(1):E22–32.PubMed
41.
Chen ZP, Stephens TJ, Murthy S, Canny BJ, Hargreaves M, Witters LA, et al. Effect of exercise intensity on skeletal muscle AMPK signaling in humans. Diabetes. 2003;52(9):2205–12.PubMed
42.
Smith BK, Marcinko K, Desjardins EM, Lally JS, Ford RJ, Steinberg GR. Treatment of nonalcoholic fatty liver disease: role of AMPK. Am J Physiol Endocrinol Metab. 2016;311(4):E730–e740.PubMed
43.
Woo JH, Shin KO, Lee YH, Jang KS, Bae JY, Roh HT. Effects of treadmill exercise on skeletal muscle mTOR signaling pathway in high-fat diet-induced obese mice. J Phys Ther Sci. 2016;28(4):1260–5.PubMedPubMedCentral
44.
Ropelle ER, Fernandes MFA, Flores MBS, Ueno M, Rocco S, Marin R, et al. Central exercise action increases the AMPK and mTOR response to leptin. PLoS One. 2008;3(12):e3856.PubMedPubMedCentral
45.
Piguet AC, Saran U, Simillion C, Keller I, Terracciano L, Reeves HL, et al. Regular exercise decreases liver tumors development in hepatocyte-specific PTEN-deficient mice independently of steatosis. J Hepatol. 2015;62(6):1296–303.PubMed
46.
American College of Sports M et al. ACSM's guidelines for exercise testing and prescription. 2018.
47.
• Glass OK, Radia A, Kraus WE, Abdelmalek MF. Exercise training as treatment of nonalcoholic fatty liver disease. J Funct Morphol Kinesiol. 2017;2(4):35.
48.
Wang S-T, et al. Physical activity intervention for non-diabetic patients with non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2020;20(1):66.PubMedPubMedCentral
49.
Shojaee-Moradie F, Cuthbertson DJ, Barrett M, Jackson NC, Herring R, Thomas EL, et al. Exercise training reduces liver fat and increases rates of VLDL clearance but not VLDL production in NAFLD. J Clin Endocrinol Metab. 2016;101(11):4219–28.PubMed
50.
García-Hermoso A, Ramírez-Vélez R, Ramírez-Campillo R, Peterson MD, Martínez-Vizcaíno V. Concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity: a systematic review and meta-analysis. Br J Sports Med. 2018;52(3):161–6.PubMed
51.
Villareal DT, Aguirre L, Gurney AB, Waters DL, Sinacore DR, Colombo E, et al. Aerobic or resistance exercise, or both, in dieting obese older adults. N Engl J Med. 2017;376(20):1943–55.PubMedPubMedCentral
52.
Singh AK, Kaur N, Kaushal S, Tyagi R, Mathur D, Sivapuram MS, et al. Partitioning of radiological, stress and biochemical changes in pre-diabetic women subjected to Diabetic Yoga Protocol. Diabetes Metab Syndr. 2019;13(4):2705–13.PubMed
53.
Keymasi Z, Sadeghi A, Pourrazi H. Effect of pilates training on hepatic fat content and liver enzymes in men with non-alcoholic fatty liver disease in Qazvin. J Shahrekord Univ Med Sci. 2020;22(1):22–8.
54.
Liu X, Miller YD, Burton NW, Brown WJ. A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health-related quality of life, and psychological health in adults with elevated blood glucose. Br J Sports Med. 2010;44(10):704–9.PubMed
55.
Hallsworth K, Thoma C, Hollingsworth KG, Cassidy S, Anstee QM, Day CP, et al. Modified high-intensity interval training reduces liver fat and improves cardiac function in non-alcoholic fatty liver disease: a randomized controlled trial. Clin Sci (Lond). 2015;129(12):1097–105.
56.
• Abdelbasset WK, Tantawy SA, Kamel DM, Alqahtani BA, Elnegamy TE, Soliman GS, et al. Effects of high-intensity interval and moderate-intensity continuous aerobic exercise on diabetic obese patients with nonalcoholic fatty liver disease: a comparative randomized controlled trial. Medicine (Baltimore). 2020;99(10):e19471.
57.
58.
Zhang HJ, He J, Pan LL, Ma ZM, Han CK, Chen CS, et al. Effects of moderate and vigorous exercise on nonalcoholic fatty liver disease: a randomized clinical trial. JAMA Intern Med. 2016;176(8):1074–82.PubMed
59.
EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64(6):1388–402.
60.
Houghton D, et al. Exercise reduces liver lipids and visceral adiposity in patients with nonalcoholic steatohepatitis in a randomized controlled trial. Clin Gastroenterol Hepatol. 2017;15(1):96–102.e3.PubMedPubMedCentral
61.
Pugh CJ, et al. Exercise training improves cutaneous microvascular function in nonalcoholic fatty liver disease. Am J Physiol Endocrinol Metab. 2013;305(1):E50–8.PubMed
62.
Pugh CJA, Sprung VS, Kemp GJ, Richardson P, Shojaee-Moradie F, Umpleby AM, et al. Exercise training reverses endothelial dysfunction in nonalcoholic fatty liver disease. Am J Phys Heart Circ Phys. 2014;307(9):H1298–306.
63.
Zelber-Sagi S, Buch A, Yeshua H, Vaisman N, Webb M, Harari G, et al. Effect of resistance training on non-alcoholic fatty-liver disease a randomized-clinical trial. World J Gastroenterol. 2014;20(15):4382–92.PubMedPubMedCentral
64.
Shamsoddini A, Sobhani V, Ghamar Chehreh ME, Alavian SM, Zaree A. Effect of aerobic and resistance exercise training on liver enzymes and hepatic fat in Iranian men with nonalcoholic fatty liver disease. Hepat Mon. 2015;15(10):e31434.PubMedPubMedCentral
65.
Cuthbertson DJ, Shojaee-Moradie F, Sprung VS, Jones H, Pugh CJA, Richardson P, et al. Dissociation between exercise-induced reduction in liver fat and changes in hepatic and peripheral glucose homoeostasis in obese patients with non-alcoholic fatty liver disease. Clin Sci (Lond). 2016;130(2):93–104.
66.
Jia GY, Han T, Gao L, Wang L, Wang SC, Yang L, et al. Effect of aerobic exercise and resistance exercise in improving non-alcoholic fatty liver disease: a randomized controlled trial. Zhonghua Gan Zang Bing Za Zhi. 2018;26(1):34–41.PubMed
67.
Sargeant JA, Gray LJ, Bodicoat DH, Willis SA, Stensel DJ, Nimmo MA, et al. The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: a systematic review and meta-analysis. Obes Rev. 2018;19(10):1446–59.PubMed
68.
Lazo M, Solga SF, Horska A, Bonekamp S, Diehl AM, Brancati FL, et al. Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes. Diabetes Care. 2010;33(10):2156–63.PubMedPubMedCentral
69.
70.
Kleiner DE, Brunt EM, van Natta M, Behling C, Contos MJ, Cummings OW, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41(6):1313–21.PubMed
71.
Filozof C, Chow SC, Dimick-Santos L, Chen YF, Williams RN, Goldstein BJ, et al. Clinical endpoints and adaptive clinical trials in precirrhotic nonalcoholic steatohepatitis: facilitating development approaches for an emerging epidemic. Hepatol Commun. 2017;1(7):577–85.PubMedPubMedCentral
72.
Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010;51(1):121–9.PubMedPubMedCentral
73.
Vilar-Gomez E, et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology. 2015;149(2):367–78.e5 quiz e14–5.PubMed
74.
Stepanova M, Rafiq N, Makhlouf H, Agrawal R, Kaur I, Younoszai Z, et al. Predictors of all-cause mortality and liver-related mortality in patients with non-alcoholic fatty liver disease (NAFLD). Dig Dis Sci. 2013;58(10):3017–23.PubMed
75.
Lee SB, Park GM, Lee JY, Lee BU, Park JH, Kim BG, et al. Association between non-alcoholic fatty liver disease and subclinical coronary atherosclerosis: an observational cohort study. J Hepatol. 2018;68(5):1018–24.PubMed
76.
Green DJ, Jones H, Thijssen D, Cable NT, Atkinson G. Flow-mediated dilation and cardiovascular event prediction: does nitric oxide matter? Hypertension. 2011;57(3):363–9.PubMed
77.
Yeboah J, Sutton-Tyrrell K, Mcburnie MA, Burke GL, Herrington DM, Crouse JR. Association between brachial artery reactivity and cardiovascular disease status in an elderly cohort: the cardiovascular health study. Atherosclerosis. 2008;197(2):768–76.PubMed
78.
Inaba Y, Chen JA, Bergmann SR. Prediction of future cardiovascular outcomes by flow-mediated vasodilatation of brachial artery: a meta-analysis. Int J Card Imaging. 2010;26(6):631–40.
79.
Gonzalez-Paredes FJ, Hernández Mesa G, Morales Arraez D, Marcelino Reyes R, Abrante B, Diaz-Flores F, et al. Contribution of cyclooxygenase end products and oxidative stress to intrahepatic endothelial dysfunction in early non-alcoholic fatty liver disease. PLoS One. 2016;11(5):e0156650.PubMedPubMedCentral
80.
Sapmaz F, Uzman M, Basyigit S, Ozkan S, Yavuz B, Yeniova A, et al. Steatosis grade is the most important risk factor for development of endothelial dysfunction in NAFLD. Medicine (Baltimore). 2016;95(14):e3280.
81.
Thakur ML, Sharma S, Kumar A, Bhatt SP, Luthra K, Guleria R, et al. Nonalcoholic fatty liver disease is associated with subclinical atherosclerosis independent of obesity and metabolic syndrome in Asian Indians. Atherosclerosis. 2012;223(2):507–11.PubMed
82.
van der Poorten D, Milner KL, Hui J, Hodge A, Trenell MI, Kench JG, et al. Visceral fat: a key mediator of steatohepatitis in metabolic liver disease. Hepatology. 2008;48(2):449–57.PubMed
83.
Bergman RN, et al. Why visceral fat is bad: mechanisms of the metabolic syndrome. Obesity (Silver Spring). 2006;14(Suppl 1):16s–9s.
84.
Hallsworth K, Fattakhova G, Hollingsworth KG, Thoma C, Moore S, Taylor R, et al. Resistance exercise reduces liver fat and its mediators in non-alcoholic fatty liver disease independent of weight loss. Gut. 2011;60(9):1278–83.PubMedPubMedCentral
85.
Oh S, So R, Shida T, Matsuo T, Kim B, Akiyama K, et al. High-intensity aerobic exercise improves both hepatic fat content and stiffness in sedentary obese men with nonalcoholic fatty liver disease. Sci Rep. 2017;7:43029–43029.
86.
Bredella MA. Sex differences in body composition. Adv Exp Med Biol. 2017;1043:9–27.PubMed
87.
Caudwell P, et al. No sex difference in body fat in response to supervised and measured exercise. Med Sci Sports Exerc. 2013;45(2):351–8.PubMed
88.
Lonardo A, Nascimbeni F, Ballestri S, Fairweather DL, Win S, Than TA, et al. Sex differences in nonalcoholic fatty liver disease: state of the art and identification of research gaps. Hepatology. 2019;70(4):1457–69.PubMedPubMedCentral
Metadaten
Titel
Exercise as Medicine: The Impact of Exercise Training on Nonalcoholic Fatty Liver Disease
verfasst von
Audrey Thorp
Jonathan G. Stine
Publikationsdatum
09.09.2020
Verlag
Springer US
Erschienen in
Current Hepatology Reports / Ausgabe 4/2020
Elektronische ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-020-00543-9

Weitere Artikel der Ausgabe 4/2020

Current Hepatology Reports 4/2020 Zur Ausgabe

Hepatitis B (JK Lim, Section Editor)

Chronic Hepatitis B and HIV Coinfection: a Continuing Challenge in the Era of Antiretroviral Therapy

Hepatic Cancer (N Parikh, Section Editor)

Genomic Landscape of HCC

Hepatitis B (JK Lim, Section Editor)

Role of Nucleic Acid Polymers and Entry Inhibitors in Functional Cure Strategies for HBV

Hepatitis B (JK Lim, Section Editor)

Diagnosis and Management of Occult Hepatitis B Infection

Hepatitis B (JK Lim, Section Editor)

The Role of RNA Interference in Functional Cure Strategies for Chronic Hepatitis B

Hepatic Cancer (N Parikh, Section Editor)

A Contemporary Approach to Diagnosis and Treatment of Combined Hepatocellular-Cholangiocarcinoma

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Battle of Experts: Sport vs. Spritze bei Adipositas und Typ-2-Diabetes

11.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Im Battle of Experts traten zwei Experten auf dem Diabeteskongress gegeneinander an: Die eine vertrat die Auffassung „Sport statt Spritze“ bei Adipositas und Typ-2-Diabetes, der andere forderte „Spritze statt Sport!“ Am Ende waren sie sich aber einig: Die Kombination aus beidem erzielt die besten Ergebnisse.

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

10.05.2024 Hypercholesterinämie Nachrichten

Patienten mit Arteriosklerose-bedingten kardiovaskulären Erkrankungen, die trotz Statineinnahme zu hohe Triglyzeridspiegel haben, profitieren von einer Behandlung mit Icosapent-Ethyl, und zwar unabhängig vom individuellen Risikoprofil.

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

10.05.2024 Periphere arterielle Verschlusskrankheit Nachrichten

In den USA ist erstmals eine bioresorbierbare Gefäßstütze – auch Scaffold genannt – zur Rekanalisation infrapoplitealer Arterien bei schwerer PAVK zugelassen worden. Das markiert einen Wendepunkt in der Geschichte dieser speziellen Gefäßstützen.

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise