Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Monday, 12 / 10 / 2018

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Non-alcoholic Fatty Liver Disease: A Clinical Update

REVIEW ARTICLE

Non-alcoholic Fatty Liver Disease: A Clinical Update

Joseph M Pappachan*,1, Shithu Babu2, Babu Krishnan3 and Nishal C Ravindran4

1Department of Endocrinology, Diabetes & Metabolism, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Lancaster, UK
2Department of Medicine, Dorset County Hospital, Dorchester, UK
3Department of Gastroenterology & Hepatology, Royal Bournemouth Hospital, Bournemouth, UK
4Department of Gastroenterology & Hepatology, Hinchingbrooke Hospital, Hinchingbrooke, Huntingdon, UK

*Correspondence to: Dr. Joseph M Pappachan, Department of Endocrinology, Diabetes & Metabolism, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Lancaster, LA1 4RP, UK. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2017;5(4):384-393 DOI: 10.14218/JCTH.2017.00013

Received: February 24, 2017 Accepted: June 24, 2017 Published online: July 26, 2017

Abstract

Non-alcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease in developed countries because of the obesity epidemic. The disease increases liver-related morbidity and mortality, and often increases the risk for other comorbidities, such as type 2 diabetes and cardiovascular disease. Insulin resistance related to metabolic syndrome is the main pathogenic trigger that, in association with adverse genetic, humoral, hormonal and lifestyle factors, precipitates development of NAFLD. Biochemical markers and radiological imaging, along with liver biopsy in selected cases, help in diagnosis and prognostication. Intense lifestyle changes aiming at weight loss are the main therapeutic intervention to manage cases. Insulin sensitizers, antioxidants, lipid lowering agents, incretin-based drugs, weight loss medications, bariatric surgery and liver transplantation may be necessary for management in some cases along with lifestyle measures. This review summarizes the latest evidence on the epidemiology, natural history, pathogenesis, diagnosis and management of NAFLD.

Keywords

Nonalcoholic fatty liver disease (NAFLD), Nonalcoholic steatohepatitis, NASH, Insulin resistance, Metabolic syndrome, Lifestyle interventions, Bariatric surgery

 

Journal of Clinical and Translational Hepatology 2017 vol. 5, 384-393 Html ] [ PDF Full-text ]

© The Authors 2017. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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