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Erschienen in: Der Diabetologe 3/2007

01.06.2007 | Leitthema

Neue Therapiemöglichkeiten bei nichtalkoholischer Fettleber

verfasst von: T. Pusl, Prof. Dr. B. Göke

Erschienen in: Die Diabetologie | Ausgabe 3/2007

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Zusammenfassung

Aufgrund der pathophysiologischen Relevanz der Insulinresistenz stellt die Änderung des Lebensstils mit moderater Gewichtsreduktion und Aktivitätssteigerung die Basistherapie bei übergewichtigen Patienten dar. Die pharmakologische Behandlung von Patienten mit nichtalkoholischer Fettleber ist bislang durch prospektive Studien noch nicht ausreichend belegt, sodass eindeutige, evidenzbasierte Therapieempfehlungen bislang nicht möglich sind. Problematisch ist auch das Fehlen validierter, nichtinvasiver Parameter zur Beurteilung des histopathologischen Gradings und Stagings. Die bisherigen Ergebnisse aus Pilotstudien mit Metformin oder Insulinsensitizern aus der Gruppe der Thiazolidindione sind viel versprechend, müssen allerdings durch prospektive, kontrollierte und randomisierte Studien an ausreichend großen Kollektiven bestätigt werden. Vitamin E und Ursodeoxycholsäure können derzeit nach der aktuellen Studienlage nicht empfohlen werden.
Literatur
1.
Zurück zum Zitat Abdelmalek MF, Angulo P, Jorgensen RA et al. (2001) Betaine, a promising new agent for patients with nonalcoholic steatohepatitis: results of a pilot study. Am J Gastroenterol 96: 2711–2717CrossRefPubMed Abdelmalek MF, Angulo P, Jorgensen RA et al. (2001) Betaine, a promising new agent for patients with nonalcoholic steatohepatitis: results of a pilot study. Am J Gastroenterol 96: 2711–2717CrossRefPubMed
2.
Zurück zum Zitat Abiru S, Migita K, Maeda Y et al. (2006) Serum cytokine and soluble cytokine receptor levels in patients with non-alcoholic steatohepatitis. Liver Int 26: 39–45CrossRefPubMed Abiru S, Migita K, Maeda Y et al. (2006) Serum cytokine and soluble cytokine receptor levels in patients with non-alcoholic steatohepatitis. Liver Int 26: 39–45CrossRefPubMed
3.
Zurück zum Zitat Adams LA, Angulo P (2006) Treatment of non-alcoholic fatty liver disease. Postgrad Med J 82: 315–322CrossRefPubMed Adams LA, Angulo P (2006) Treatment of non-alcoholic fatty liver disease. Postgrad Med J 82: 315–322CrossRefPubMed
4.
Zurück zum Zitat Adams LA, Zein CO, Angulo P, Lindor KD (2004) A pilot trial of pentoxifylline in nonalcoholic steatohepatitis. Am J Gastroenterol 99: 2365–2368CrossRefPubMed Adams LA, Zein CO, Angulo P, Lindor KD (2004) A pilot trial of pentoxifylline in nonalcoholic steatohepatitis. Am J Gastroenterol 99: 2365–2368CrossRefPubMed
5.
Zurück zum Zitat Basaranoglu M, Acbay O, Sonsuz A (1999) A controlled trial of gemfibrozil in the treatment of patients with nonalcoholic steatohepatitis. J Hepatol 31: 384CrossRefPubMed Basaranoglu M, Acbay O, Sonsuz A (1999) A controlled trial of gemfibrozil in the treatment of patients with nonalcoholic steatohepatitis. J Hepatol 31: 384CrossRefPubMed
6.
Zurück zum Zitat Bauditz J, Schmidt HH, Dippe P et al. (2004) Non-alcohol induced steatohepatitis in non-obese patients: treatment with ursodeoxycholic acid. Am J Gastroenterol 99: 959–960CrossRefPubMed Bauditz J, Schmidt HH, Dippe P et al. (2004) Non-alcohol induced steatohepatitis in non-obese patients: treatment with ursodeoxycholic acid. Am J Gastroenterol 99: 959–960CrossRefPubMed
7.
Zurück zum Zitat Belfort R, Harrison SA, Brown K et al. (2006) A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis. N Engl J Med 355: 2297–2307CrossRefPubMed Belfort R, Harrison SA, Brown K et al. (2006) A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis. N Engl J Med 355: 2297–2307CrossRefPubMed
8.
Zurück zum Zitat Bugianesi E, Gentilcore E, Manini R et al. (2005) A randomized controlled trial of metformin versus vitamin E or prescriptive diet in nonalcoholic fatty liver disease. Am J Gastroenterol 100: 1082–1090CrossRefPubMed Bugianesi E, Gentilcore E, Manini R et al. (2005) A randomized controlled trial of metformin versus vitamin E or prescriptive diet in nonalcoholic fatty liver disease. Am J Gastroenterol 100: 1082–1090CrossRefPubMed
9.
Zurück zum Zitat Buscher HP (2004) [Nonalcoholic steatohepatitis (NASH): therapeutic approaches]. Dtsch Med Wochenschr 129 Suppl 2: S60-S62CrossRef Buscher HP (2004) [Nonalcoholic steatohepatitis (NASH): therapeutic approaches]. Dtsch Med Wochenschr 129 Suppl 2: S60-S62CrossRef
10.
Zurück zum Zitat Caldwell SH, Argo CK, Al Osaimi AM (2006) Therapy of NAFLD: insulin sensitizing agents. J Clin Gastroenterol 40: S61-S66PubMed Caldwell SH, Argo CK, Al Osaimi AM (2006) Therapy of NAFLD: insulin sensitizing agents. J Clin Gastroenterol 40: S61-S66PubMed
11.
Zurück zum Zitat Caldwell SH, Hespenheide EE, Redick JA et al. (2001) A pilot study of a thiazolidinedione, troglitazone, in nonalcoholic steatohepatitis. Am J Gastroenterol 96: 519–525CrossRefPubMed Caldwell SH, Hespenheide EE, Redick JA et al. (2001) A pilot study of a thiazolidinedione, troglitazone, in nonalcoholic steatohepatitis. Am J Gastroenterol 96: 519–525CrossRefPubMed
12.
Zurück zum Zitat Ceriani R, Brunati S, Morini L et al. (1998) Effect of ursodeoxycholic acid plus diet in patients with nonalcoholic steatohepatitis. Hepatology (28): 386 Ceriani R, Brunati S, Morini L et al. (1998) Effect of ursodeoxycholic acid plus diet in patients with nonalcoholic steatohepatitis. Hepatology (28): 386
13.
Zurück zum Zitat Charlton M, Kasparova P, Weston S et al. (2001) Frequency of nonalcoholic steatohepatitis as a cause of advanced liver disease. Liver Transpl 7: 608–614CrossRefPubMed Charlton M, Kasparova P, Weston S et al. (2001) Frequency of nonalcoholic steatohepatitis as a cause of advanced liver disease. Liver Transpl 7: 608–614CrossRefPubMed
14.
Zurück zum Zitat Clark JM (2006) Weight loss as a treatment for nonalcoholic fatty liver disease. J Clin Gastroenterol 40: S39–S43PubMed Clark JM (2006) Weight loss as a treatment for nonalcoholic fatty liver disease. J Clin Gastroenterol 40: S39–S43PubMed
15.
Zurück zum Zitat Clark JM, Alkhuraishi AR, Solga SF et al. (2005) Roux-en-Y gastric bypass improves liver histology in patients with non-alcoholic fatty liver disease. Obes Res 13: 1180–1186PubMed Clark JM, Alkhuraishi AR, Solga SF et al. (2005) Roux-en-Y gastric bypass improves liver histology in patients with non-alcoholic fatty liver disease. Obes Res 13: 1180–1186PubMed
16.
Zurück zum Zitat Contos MJ, Cales W, Sterling RK et al. (2001) Development of nonalcoholic fatty liver disease after orthotopic liver transplantation for cryptogenic cirrhosis. Liver Transpl 7: 363–373CrossRefPubMed Contos MJ, Cales W, Sterling RK et al. (2001) Development of nonalcoholic fatty liver disease after orthotopic liver transplantation for cryptogenic cirrhosis. Liver Transpl 7: 363–373CrossRefPubMed
17.
Zurück zum Zitat Dancygier H (2006) Nichtalkoholische Fettlebererkrankungen. Der Gastoenterologe 1: 221–230CrossRef Dancygier H (2006) Nichtalkoholische Fettlebererkrankungen. Der Gastoenterologe 1: 221–230CrossRef
18.
Zurück zum Zitat Dancygier H (2006) Pathogenese und Therapie der nichtalkoholischen Fettlebererkrankungen. Deutsches Ärzteblatt 103: 1301–1307 Dancygier H (2006) Pathogenese und Therapie der nichtalkoholischen Fettlebererkrankungen. Deutsches Ärzteblatt 103: 1301–1307
19.
Zurück zum Zitat Dixon JB, Bhathal PS, Hughes NR, O’Brien PE (2004) Nonalcoholic fatty liver disease: Improvement in liver histological analysis with weight loss. Hepatology 39: 1647–1654CrossRefPubMed Dixon JB, Bhathal PS, Hughes NR, O’Brien PE (2004) Nonalcoholic fatty liver disease: Improvement in liver histological analysis with weight loss. Hepatology 39: 1647–1654CrossRefPubMed
20.
Zurück zum Zitat Facchini FS, Hua NW, Stoohs RA (2002) Effect of iron depletion in carbohydrate-intolerant patients with clinical evidence of nonalcoholic fatty liver disease. Gastroenterology 122: 931–939CrossRefPubMed Facchini FS, Hua NW, Stoohs RA (2002) Effect of iron depletion in carbohydrate-intolerant patients with clinical evidence of nonalcoholic fatty liver disease. Gastroenterology 122: 931–939CrossRefPubMed
21.
Zurück zum Zitat Gulbahar O, Karasu ZA, Ersoz G et al. (2000) Treatment of non-alcoholic steatohepatitis with N-acetylcysteine. Gastroenterology 118: ∎ Gulbahar O, Karasu ZA, Ersoz G et al. (2000) Treatment of non-alcoholic steatohepatitis with N-acetylcysteine. Gastroenterology 118: ∎
22.
Zurück zum Zitat Guma G, Viola L, Thom M et al. (1997) Ursodeoxycholic acid in the treatment of nonalcoholic steatohepatitis: results of a prospective clinical controlled trial. Hepatology (26): 387 Guma G, Viola L, Thom M et al. (1997) Ursodeoxycholic acid in the treatment of nonalcoholic steatohepatitis: results of a prospective clinical controlled trial. Hepatology (26): 387
23.
Zurück zum Zitat Harrison SA, Fincke C, Helinski D et al. (2004) A pilot study of orlistat treatment in obese, non-alcoholic steatohepatitis patients. Aliment Pharmacol Ther 20: 623–628CrossRefPubMed Harrison SA, Fincke C, Helinski D et al. (2004) A pilot study of orlistat treatment in obese, non-alcoholic steatohepatitis patients. Aliment Pharmacol Ther 20: 623–628CrossRefPubMed
24.
Zurück zum Zitat Harrison SA, Ramrakhiani S, Brunt EM et al. (2003) Orlistat in the treatment of NASH: a case series. Am J Gastroenterol 98: 926–930CrossRefPubMed Harrison SA, Ramrakhiani S, Brunt EM et al. (2003) Orlistat in the treatment of NASH: a case series. Am J Gastroenterol 98: 926–930CrossRefPubMed
25.
Zurück zum Zitat Harrison SA, Torgerson S, Hayashi P et al. (2003) Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis. Am J Gastroenterol 98: 2485–2490CrossRefPubMed Harrison SA, Torgerson S, Hayashi P et al. (2003) Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis. Am J Gastroenterol 98: 2485–2490CrossRefPubMed
26.
Zurück zum Zitat Hatzitolios A, Savopoulos C, Lazaraki G et al. (2004) Efficacy of omega-3 fatty acids, atorvastatin and orlistat in non-alcoholic fatty liver disease with dyslipidemia. Indian J Gastroenterol 23: 131–134PubMed Hatzitolios A, Savopoulos C, Lazaraki G et al. (2004) Efficacy of omega-3 fatty acids, atorvastatin and orlistat in non-alcoholic fatty liver disease with dyslipidemia. Indian J Gastroenterol 23: 131–134PubMed
27.
Zurück zum Zitat Kim WR, Poterucha JJ, Porayko MK et al. (1996) Recurrence of nonalcoholic steatohepatitis following liver transplantation. Transplantation 62: 1802–1805CrossRefPubMed Kim WR, Poterucha JJ, Porayko MK et al. (1996) Recurrence of nonalcoholic steatohepatitis following liver transplantation. Transplantation 62: 1802–1805CrossRefPubMed
28.
Zurück zum Zitat Kirpichnikov D, McFarlane SI, Sowers JR (2002) Metformin: an update. Ann Intern Med 137: 25–33PubMed Kirpichnikov D, McFarlane SI, Sowers JR (2002) Metformin: an update. Ann Intern Med 137: 25–33PubMed
29.
Zurück zum Zitat Kiyici M, Gulten M, Gurel S et al. (2003) Ursodeoxycholic acid and atorvastatin in the treatment of nonalcoholic steatohepatitis. Can J Gastroenterol 17: 713–718PubMed Kiyici M, Gulten M, Gurel S et al. (2003) Ursodeoxycholic acid and atorvastatin in the treatment of nonalcoholic steatohepatitis. Can J Gastroenterol 17: 713–718PubMed
30.
Zurück zum Zitat Kluwe J, Lohse AW (2005) [Therapeutic options for nonalcoholic fatty liver disease and steatohepatitis]. Internist (Berl) 46: 1324–1330 Kluwe J, Lohse AW (2005) [Therapeutic options for nonalcoholic fatty liver disease and steatohepatitis]. Internist (Berl) 46: 1324–1330
31.
Zurück zum Zitat Laurin J, Lindor KD, Crippin JS et al. (1996) Ursodeoxycholic acid or clofibrate in the treatment of non-alcohol-induced steatohepatitis: a pilot study. Hepatology 23: 1464–1467CrossRefPubMed Laurin J, Lindor KD, Crippin JS et al. (1996) Ursodeoxycholic acid or clofibrate in the treatment of non-alcohol-induced steatohepatitis: a pilot study. Hepatology 23: 1464–1467CrossRefPubMed
32.
Zurück zum Zitat Lavine JE (2000) Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study. J Pediatr 136: 734–738CrossRefPubMed Lavine JE (2000) Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study. J Pediatr 136: 734–738CrossRefPubMed
33.
Zurück zum Zitat Lin HZ, Yang SQ, Chuckaree C et al. (2000) Metformin reverses fatty liver disease in obese, leptin-deficient mice. Nat Med 6: 998–1003CrossRefPubMed Lin HZ, Yang SQ, Chuckaree C et al. (2000) Metformin reverses fatty liver disease in obese, leptin-deficient mice. Nat Med 6: 998–1003CrossRefPubMed
34.
Zurück zum Zitat Lindor KD, Kowdley KV, Heathcote EJ et al. (2004) Ursodeoxycholic acid for treatment of nonalcoholic steatohepatitis: results of a randomized trial. Hepatology 39: 770–778CrossRefPubMed Lindor KD, Kowdley KV, Heathcote EJ et al. (2004) Ursodeoxycholic acid for treatment of nonalcoholic steatohepatitis: results of a randomized trial. Hepatology 39: 770–778CrossRefPubMed
35.
Zurück zum Zitat Machado M, Cortez-Pinto H (2006) Nash, insulin resistance and iron. Liver Int 26: 1159–1162CrossRefPubMed Machado M, Cortez-Pinto H (2006) Nash, insulin resistance and iron. Liver Int 26: 1159–1162CrossRefPubMed
36.
Zurück zum Zitat Marchesini G, Brizi M, Bianchi G et al. (2001) Metformin in non-alcoholic steatohepatitis. Lancet 358: 893–894CrossRefPubMed Marchesini G, Brizi M, Bianchi G et al. (2001) Metformin in non-alcoholic steatohepatitis. Lancet 358: 893–894CrossRefPubMed
37.
Zurück zum Zitat Mattar SG, Velcu LM, Rabinovitz M et al. (2005) Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Ann Surg 242: 610–617PubMed Mattar SG, Velcu LM, Rabinovitz M et al. (2005) Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Ann Surg 242: 610–617PubMed
38.
Zurück zum Zitat Mendez-Sanchez N, Gonzalez V, Chavez-Tapia N et al. (2004) Weight reduction and ursodeoxycholic acid in subjects with nonalcoholic fatty liver disease. A double-blind, placebo-controlled trial. Ann Hepatol 3: 108–112PubMed Mendez-Sanchez N, Gonzalez V, Chavez-Tapia N et al. (2004) Weight reduction and ursodeoxycholic acid in subjects with nonalcoholic fatty liver disease. A double-blind, placebo-controlled trial. Ann Hepatol 3: 108–112PubMed
39.
Zurück zum Zitat Merat S, Malekzadeh R, Sohrabi MR et al. (2003) Probucol in the treatment of nonalcoholic steatohepatitis: an open-labeled study. J Clin Gastroenterol 36: 266–268CrossRefPubMed Merat S, Malekzadeh R, Sohrabi MR et al. (2003) Probucol in the treatment of nonalcoholic steatohepatitis: an open-labeled study. J Clin Gastroenterol 36: 266–268CrossRefPubMed
40.
Zurück zum Zitat Merat S, Malekzadeh R, Sohrabi MR et al. (2003) Probucol in the treatment of non-alcoholic steatohepatitis: a double-blind randomized controlled study. J Hepatol 38: 414–418CrossRefPubMed Merat S, Malekzadeh R, Sohrabi MR et al. (2003) Probucol in the treatment of non-alcoholic steatohepatitis: a double-blind randomized controlled study. J Hepatol 38: 414–418CrossRefPubMed
41.
Zurück zum Zitat Miglio F, Rovati LC, Santoro A, Setnikar I (2000) Efficacy and safety of oral betaine glucuronate in non-alcoholic steatohepatitis. A double-blind, randomized, parallel-group, placebo-controlled prospective clinical study. Arzneimittelforschung 50: 722–727PubMed Miglio F, Rovati LC, Santoro A, Setnikar I (2000) Efficacy and safety of oral betaine glucuronate in non-alcoholic steatohepatitis. A double-blind, randomized, parallel-group, placebo-controlled prospective clinical study. Arzneimittelforschung 50: 722–727PubMed
42.
Zurück zum Zitat Miller ER III, Pastor-Barriuso R, Dalal D et al. (2005) Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 142: 37–46PubMed Miller ER III, Pastor-Barriuso R, Dalal D et al. (2005) Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 142: 37–46PubMed
43.
Zurück zum Zitat Nair S, Diehl AM, Wiseman M et al. (2004) Metformin in the treatment of non-alcoholic steatohepatitis: a pilot open label trial. Aliment Pharmacol Ther 20: 23–28CrossRef Nair S, Diehl AM, Wiseman M et al. (2004) Metformin in the treatment of non-alcoholic steatohepatitis: a pilot open label trial. Aliment Pharmacol Ther 20: 23–28CrossRef
44.
Zurück zum Zitat Neuschwander-Tetri BA, Brunt EM, Wehmeier KR et al. (2003) Improved nonalcoholic steatohepatitis after 48 weeks of treatment with the PPAR-gamma ligand rosiglitazone. Hepatology 38: 1008–1017CrossRefPubMed Neuschwander-Tetri BA, Brunt EM, Wehmeier KR et al. (2003) Improved nonalcoholic steatohepatitis after 48 weeks of treatment with the PPAR-gamma ligand rosiglitazone. Hepatology 38: 1008–1017CrossRefPubMed
45.
Zurück zum Zitat Obinata K, Maruyama T, Hayashi M et al. (1996) Effect of taurine on the fatty liver of children with simple obesity. Adv Exp Med Biol 403: 607–613PubMed Obinata K, Maruyama T, Hayashi M et al. (1996) Effect of taurine on the fatty liver of children with simple obesity. Adv Exp Med Biol 403: 607–613PubMed
46.
Zurück zum Zitat Promrat K, Lutchman G, Uwaifo GI et al. (2004) A pilot study of pioglitazone treatment for nonalcoholic steatohepatitis. Hepatology 39: 188–196CrossRefPubMed Promrat K, Lutchman G, Uwaifo GI et al. (2004) A pilot study of pioglitazone treatment for nonalcoholic steatohepatitis. Hepatology 39: 188–196CrossRefPubMed
47.
Zurück zum Zitat Rallidis LS, Drakoulis CK, Parasi AS (2004) Pravastatin in patients with nonalcoholic steatohepatitis: results of a pilot study. Atherosclerosis 174: 193–196CrossRefPubMed Rallidis LS, Drakoulis CK, Parasi AS (2004) Pravastatin in patients with nonalcoholic steatohepatitis: results of a pilot study. Atherosclerosis 174: 193–196CrossRefPubMed
48.
Zurück zum Zitat Sabuncu T, Nazligul Y, Karaoglanoglu M et al. (2003) The effects of sibutramine and orlistat on the ultrasonographic findings, insulin resistance and liver enzyme levels in obese patients with non-alcoholic steatohepatitis. Rom J Gastroenterol 12: 189–192PubMed Sabuncu T, Nazligul Y, Karaoglanoglu M et al. (2003) The effects of sibutramine and orlistat on the ultrasonographic findings, insulin resistance and liver enzyme levels in obese patients with non-alcoholic steatohepatitis. Rom J Gastroenterol 12: 189–192PubMed
49.
Zurück zum Zitat Sanjeevi A, Lyden E, Sunderman B et al. (2003) Outcomes of liver transplantation for cryptogenic cirrhosis: a single-center study of 71 patients. Transplant Proc 35: 2977–2980CrossRefPubMed Sanjeevi A, Lyden E, Sunderman B et al. (2003) Outcomes of liver transplantation for cryptogenic cirrhosis: a single-center study of 71 patients. Transplant Proc 35: 2977–2980CrossRefPubMed
50.
Zurück zum Zitat Santos VN, Lanzoni VP, Szejnfeld J et al. (2003) A randomized double-blind study of the short-time treatment of obese patients with nonalcoholic fatty liver disease with ursodeoxycholic acid. Braz J Med Biol Res 36: 723–729PubMed Santos VN, Lanzoni VP, Szejnfeld J et al. (2003) A randomized double-blind study of the short-time treatment of obese patients with nonalcoholic fatty liver disease with ursodeoxycholic acid. Braz J Med Biol Res 36: 723–729PubMed
51.
Zurück zum Zitat Sanyal AJ, Mofrad PS, Contos MJ et al. (2004) A pilot study of vitamin E versus vitamin E and pioglitazone for the treatment of nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol 2: 1107–1115CrossRefPubMed Sanyal AJ, Mofrad PS, Contos MJ et al. (2004) A pilot study of vitamin E versus vitamin E and pioglitazone for the treatment of nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol 2: 1107–1115CrossRefPubMed
52.
Zurück zum Zitat Satapathy SK, Garg S, Chauhan R et al. (2004) Beneficial effects of tumor necrosis factor-alpha inhibition by pentoxifylline on clinical, biochemical, and metabolic parameters of patients with nonalcoholic steatohepatitis. Am J Gastroenterol 99: 1946–1952CrossRefPubMed Satapathy SK, Garg S, Chauhan R et al. (2004) Beneficial effects of tumor necrosis factor-alpha inhibition by pentoxifylline on clinical, biochemical, and metabolic parameters of patients with nonalcoholic steatohepatitis. Am J Gastroenterol 99: 1946–1952CrossRefPubMed
53.
Zurück zum Zitat Solga S, Alkhuraishe AR, Clark JM et al. (2004) Dietary composition and nonalcoholic fatty liver disease. Dig Dis Sci 49: 1578–1583CrossRefPubMed Solga S, Alkhuraishe AR, Clark JM et al. (2004) Dietary composition and nonalcoholic fatty liver disease. Dig Dis Sci 49: 1578–1583CrossRefPubMed
54.
Zurück zum Zitat Stremmel W, Blechacz B, Herrmann T et al. (2001) [Therapy of alcoholic and non-alcoholic fatty liver]. Internist (Berl) 42: 1641–1650 Stremmel W, Blechacz B, Herrmann T et al. (2001) [Therapy of alcoholic and non-alcoholic fatty liver]. Internist (Berl) 42: 1641–1650
55.
Zurück zum Zitat Stumvoll M, Nurjhan N, Perriello G et al.(1995) Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Engl J Med 333: 550–554CrossRefPubMed Stumvoll M, Nurjhan N, Perriello G et al.(1995) Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Engl J Med 333: 550–554CrossRefPubMed
56.
Zurück zum Zitat Sumida Y, Kanemasa K, Fukumoto K et al. (2006) Effect of iron reduction by phlebotomy in Japanese patients with nonalcoholic steatohepatitis: A pilot study. Hepatol Res ■ Sumida Y, Kanemasa K, Fukumoto K et al. (2006) Effect of iron reduction by phlebotomy in Japanese patients with nonalcoholic steatohepatitis: A pilot study. Hepatol Res ■
57.
Zurück zum Zitat Tilg H (2004) Nicht-alkoholische Steatohepatitis. J Gastroenterol Hepatol Erk 2: 5–10 Tilg H (2004) Nicht-alkoholische Steatohepatitis. J Gastroenterol Hepatol Erk 2: 5–10
58.
Zurück zum Zitat Uygun A, Kadayifci A, Isik AT et al. (2004) Metformin in the treatment of patients with non-alcoholic steatohepatitis. Aliment Pharmacol Ther 19: 537–544CrossRefPubMed Uygun A, Kadayifci A, Isik AT et al. (2004) Metformin in the treatment of patients with non-alcoholic steatohepatitis. Aliment Pharmacol Ther 19: 537–544CrossRefPubMed
59.
Zurück zum Zitat Vajro P, Mandato C, Franzese A et al. (2004) Vitamin E treatment in pediatric obesity-related liver disease: a randomized study. J Pediatr Gastroenterol Nutr 38: 48–55CrossRefPubMed Vajro P, Mandato C, Franzese A et al. (2004) Vitamin E treatment in pediatric obesity-related liver disease: a randomized study. J Pediatr Gastroenterol Nutr 38: 48–55CrossRefPubMed
60.
Zurück zum Zitat Wang RT, Koretz RL, Yee HF Jr (2003) Is weight reduction an effective therapy for nonalcoholic fatty liver? A systematic review. Am J Med 115: 554–559CrossRefPubMed Wang RT, Koretz RL, Yee HF Jr (2003) Is weight reduction an effective therapy for nonalcoholic fatty liver? A systematic review. Am J Med 115: 554–559CrossRefPubMed
61.
Zurück zum Zitat Wigg AJ, Roberts-Thomson IC, Dymock RB et al. (2001) The role of small intestinal bacterial overgrowth, intestinal permeability, endotoxaemia, and tumour necrosis factor alpha in the pathogenesis of non-alcoholic steatohepatitis. Gut 48: 206–211CrossRefPubMed Wigg AJ, Roberts-Thomson IC, Dymock RB et al. (2001) The role of small intestinal bacterial overgrowth, intestinal permeability, endotoxaemia, and tumour necrosis factor alpha in the pathogenesis of non-alcoholic steatohepatitis. Gut 48: 206–211CrossRefPubMed
62.
Zurück zum Zitat Yokohama S, Yoneda M, Haneda M et al. (2004) Therapeutic efficacy of an angiotensin II receptor antagonist in patients with nonalcoholic steatohepatitis. Hepatology 40: 1222–1225CrossRefPubMed Yokohama S, Yoneda M, Haneda M et al. (2004) Therapeutic efficacy of an angiotensin II receptor antagonist in patients with nonalcoholic steatohepatitis. Hepatology 40: 1222–1225CrossRefPubMed
Metadaten
Titel
Neue Therapiemöglichkeiten bei nichtalkoholischer Fettleber
verfasst von
T. Pusl
Prof. Dr. B. Göke
Publikationsdatum
01.06.2007
Verlag
Springer-Verlag
Erschienen in
Die Diabetologie / Ausgabe 3/2007
Print ISSN: 2731-7447
Elektronische ISSN: 2731-7455
DOI
https://doi.org/10.1007/s11428-007-0118-2

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Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

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