Non-Alcoholic Fatty Liver Disease
Authors:
Radan Brůha
Authors‘ workplace:
IV. interní klinika – klinika hepatologie a gastroenterologie 1. LF UK a VFN v Praze
Published in:
Vnitř Lék 2019; 65(9): 571-575
Category:
Overview
Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of a metabolic syndrome, is a leading cause of chronic liver disease worldwide with prevalence 17–46 % in adult population. NAFLD is associated with type 2 diabetes, obesity and genetic factors and includes a spectrum of potentially progressive liver disease that comprises of simple steatosis, non-alcoholic steatohepatitis (NASH), variable degree of fibrosis and, ultimately, cirrhosis. Simple steatosis has been considered a benign condition, while the progression to fibrosis and advanced liver disease is related to NASH development. While steatosis is diagnosed by routine imaging methods, NASH could be diagnosed only by liver biopsy. Life style modification and weight reduction is the method of choice in the treatment of NAFLD. Despite intensive effort, no pharmacological treatment of NAFLD has been approved; based on the results of clinical trials the use of vitamin E or pioglitazone could be considered in the treatment of bioptically proved NASH. New antifibrotic and anti-inflammatory agents for the treatment of NASH are under evaluation. Recently, screening for NAFLD and/or advanced fibrosis in patients with type 2 diabetes has been advocated.
Keywords:
fibrosis – metabolic syndrome – NAFLD
Sources
- Chalasani N, Younossi Z, Lavine JE 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): 328–357. Dostupné z DOI: <http://dx.doi.org/10.1002/hep.29367>.
- Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011; 34(3): 274–285. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2036.2011.04724.x>.
- Zelber-Sagi S, Lotan R, Shlomai A et al. Predictors for incidence and remission of NAFLD in the general population during a seven-year prospective follow-up. J Hepatol 2012; 56(5): 1145–1151.Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2011.12.011>.
- Subichin M, Clanton J, Makuszewski M et al. Liver disease in the morbidly obese: a review of 1000 consecutive patients undergoing weight loss surgery. Surg Obes Relat Dis 2015; 11(1): 137–141. Dostupné z DOI: <http://dx.doi.org/10.1016/j.soard.2014.06.015>.
- Dvorak K, Hainer R, Petrtyl J et al. The prevalence of nonalcoholic liver steatosis in patients with type 2 diabetes mellitus in the Czech Republic. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 159(3): 442–448. Dostupné z DOI: <http://dx.doi.org/10.5507/bp.2014.033>.
- Younossi ZM, Koenig AB, Abdelatif D et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016; 64(1): 73–84. Dostupné z DOI: <http://dx.doi.org/10.1002/hep.28431>.
- Adams LA, Lymp JF, St Sauver J et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology 2005; 129(1): 113–121. Dostupné z DOI: <http://dx.doi.org/10.1053/j.gastro.2005.04.014>.
- Haflidadottir S, Jonasson JG, Norland H et al. Long-term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease. BMC Gastroenterol 2014; 14: 166. Dostupné z DOI: <http://dx.doi.org/10.1186/1471–230X-14–166>.
- Tilg H. Adipocytokines in nonalcoholic fatty liver disease: key players regulating steatosis, inflammation and fibrosis. Curr Pharm Des 2010; 16(17): 1893–1895. Dostupné z DOI: <http://dx.doi.org/10.2174/138161210791208929>.
- Hernaez R. Genetic factors associated with the presence and progression of nonalcoholic fatty liver disease: a narrative review. Gastroenterol Hepatol 2012; 35(1): 32–41. Dostupné z DOI: <http://dx.doi.org/10.1016/j.gastrohep.2011.08.002>.
- Trepo E, Romeo S, Zucman-Rossi J et al. PNPLA3 gene in liver diseases. J Hepatol 2016; 65(2): 399–412. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2016.03.011>.
- Hernaez R, Lazo M, Bonekamp S et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology 2011; 54(3): 1082–1090. Dostupné z DOI: <http://dx.doi.org/10.1002/hep.24452>.
- Yeh MM, Brunt EM. Pathological features of fatty liver disease. Gastroenterology 2014; 147(4): 754–764. Dostupné z DOI: <http://dx.doi.org/10.1053/j.gastro.2014.07.056>.
- Kleiner DE, Brunt EM, Van Natta M et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005; 41(6): 1313–1321. Dostupné z DOI: <http://dx.doi.org/10.1002/hep.20701>.
- Dvořák K. Noninvasive diagnostics in NAFLD. Gastroenterol Hepatol 2015; 69(2): 110–115. Dostupné z DOI: <http://dx.doi.org/10.14735/amgh2015110>.
- Angulo P, Hui JM, Marchesini G et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 2007; 45(4): 846–854. Dostupné z DOI: <http://dx.doi.org/10.1002/hep.21496>.
- Lichtinghagen R, Pietsch D, Bantel H et al. The Enhanced Liver Fibrosis (ELF) score: normal values, influence factors and proposed cut-off values. J Hepatol 2013; 59(2): 236–242. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2013.03.016>.
- Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L et al. Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis. Gastroenterology 2015; 149(2): 367–378.e5; quiz e14–5. Dostupné z DOI: <http://dx.doi.org/10.1053/j.gastro.2015.04.005>.
- Sanyal AJ, Chalasani N, Kowdley KV et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med 2010; 362(18): 1675–1685. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0907929>.
- Cusi K, Orsak B, Bril F et al. Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis and Prediabetes or Type 2 Diabetes Mellitus: A Randomized Trial. Ann Intern Med 2016; 165(5): 305–315. Dostupné z DOI: <http://dx.doi.org/10.7326/M15–1774>.
- Lassailly G, Caiazzo R, Buob D et al. Bariatric Surgery Reduces Features of Nonalcoholic Steatohepatitis in Morbidly Obese Patients. Gastroenterology 2015; 149(2): 379–388. Dostupné z DOI: <http://dx.doi.org/10.1053/j.gastro.2015.04.014>.
- Mathurin P, Hollebecque A, Arnalsteen L et al. Prospective study of the long-term effects of bariatric surgery on liver injury in patients without advanced disease. Gastroenterology 2009; 137(2): 532–540. Dostupné z DOI: <http://dx.doi.org/10.1053/j.gastro.2009.04.052>.
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Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2019 Issue 9
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