Onpan Cheung1, Arun J Sanyal. 1. Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia 23298-0341, USA.
Abstract
PURPOSE OF REVIEW: This review focuses on recent advances in the study of the epidemiology, pathogenesis, natural history and treatment of nonalcoholic fatty liver disease (NAFLD). RECENT FINDINGS: Study of hepatic lipid metabolism with respect to the contribution of de-novo lipogenesis to hepatic steatosis and insulin resistance and the dysregulation of cellular adaptive response to stress, that is, the unfolded protein response has added to our current understanding of NAFLD. microRNA has recently emerged and has been shown to be differentially expressed in patients with nonalcoholic steatohepatitis. Its mechanism of action remains to be further explored. There is no proven pharmacotherapy for the treatment of NAFLD. Lifestyle intervention to achieve weight loss and increase exercise is persistently associated with improved liver histology. The diagnostic utility of noninvasive markers and imaging modalities in assessing fibrosis remains to be elucidated. SUMMARY: The underlying mechanism and pathogenesis of NAFLD remain elusive. Although research effort has advanced the understanding of the natural history, pathogenesis and management of the disease, there is no proven therapy for this medical condition. At present, treatment concentrates on managing underlying metabolic risk factors.
PURPOSE OF REVIEW: This review focuses on recent advances in the study of the epidemiology, pathogenesis, natural history and treatment of nonalcoholic fatty liver disease (NAFLD). RECENT FINDINGS: Study of hepatic lipid metabolism with respect to the contribution of de-novo lipogenesis to hepatic steatosis and insulin resistance and the dysregulation of cellular adaptive response to stress, that is, the unfolded protein response has added to our current understanding of NAFLD. microRNA has recently emerged and has been shown to be differentially expressed in patients with nonalcoholic steatohepatitis. Its mechanism of action remains to be further explored. There is no proven pharmacotherapy for the treatment of NAFLD. Lifestyle intervention to achieve weight loss and increase exercise is persistently associated with improved liver histology. The diagnostic utility of noninvasive markers and imaging modalities in assessing fibrosis remains to be elucidated. SUMMARY: The underlying mechanism and pathogenesis of NAFLD remain elusive. Although research effort has advanced the understanding of the natural history, pathogenesis and management of the disease, there is no proven therapy for this medical condition. At present, treatment concentrates on managing underlying metabolic risk factors.
Authors: Q Jia; Y Xia; Q Zhang; H Wu; H Du; L Liu; C Wang; H Shi; X Guo; X Liu; C Li; S Sun; X Wang; H Zhao; K Song; G Huang; Y Wu; N Cui; K Niu Journal: Eur J Clin Nutr Date: 2015-02-04 Impact factor: 4.016
Authors: Juan P Arab; Roberto Candia; Rodrigo Zapata; Cristián Muñoz; Juan P Arancibia; Jaime Poniachik; Alejandro Soza; Francisco Fuster; Javier Brahm; Edgar Sanhueza; Jorge Contreras; M Carolina Cuellar; Marco Arrese; Arnoldo Riquelme Journal: World J Gastroenterol Date: 2014-09-14 Impact factor: 5.742
Authors: Rhiannon N Hardwick; John D Clarke; April D Lake; Mark J Canet; Tarun Anumol; Stephanie M Street; Matthew D Merrell; Michael J Goedken; Shane A Snyder; Nathan J Cherrington Journal: Toxicol Sci Date: 2014-07-31 Impact factor: 4.849