Anthony S Wierzbicki1, Jude Oben. 1. Department of Metabolic Medicine/Chemical Pathologyemical Pathology, Guy's and St. Thomas' Hospitals, London, UK. Anthony.wierzbicki@kcl.ac.uk
Abstract
PURPOSE OF REVIEW: This article reviews the mechanisms leading to the development of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) and the effects of hypoglycaemic and lipid-lowering therapies on NAFLD/NASH. RECENT FINDINGS: The interaction of lipogenesis, fatty acid oxidation, inflammation, endoplasmic reticulum stress and hepatic insulin resistance contribute to the pathogenesis of NAFLD/NASH. Few large scale clinical trials exist with biopsy or magnetic resonance endpoints as opposed to ultrasonographic and transaminase endpoints. Trial evidence that exists supports the utility of weight loss, metformin, thiazolidinediones, fibrates, niacin, ezetimibe and statins in improving the steatosis component of NAFLD/NASH though with less or minimal effects on the fibrotic component of NASH. SUMMARY: Hypoglycaemic and lipid-lowering therapies may have a role in the treatment of NAFLD/NASH but large scale endpoint trials remain to be performed.
PURPOSE OF REVIEW: This article reviews the mechanisms leading to the development of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) and the effects of hypoglycaemic and lipid-lowering therapies on NAFLD/NASH. RECENT FINDINGS: The interaction of lipogenesis, fatty acid oxidation, inflammation, endoplasmic reticulum stress and hepatic insulin resistance contribute to the pathogenesis of NAFLD/NASH. Few large scale clinical trials exist with biopsy or magnetic resonance endpoints as opposed to ultrasonographic and transaminase endpoints. Trial evidence that exists supports the utility of weight loss, metformin, thiazolidinediones, fibrates, niacin, ezetimibe and statins in improving the steatosis component of NAFLD/NASH though with less or minimal effects on the fibrotic component of NASH. SUMMARY: Hypoglycaemic and lipid-lowering therapies may have a role in the treatment of NAFLD/NASH but large scale endpoint trials remain to be performed.
Authors: Shu Wang; Nirupa R Matthan; Dayong Wu; Debra B Reed; Priyanka Bapat; Xiangling Yin; Paula Grammas; Chwan-Li Shen; Alice H Lichtenstein Journal: Clin Nutr Date: 2013-04-24 Impact factor: 7.324
Authors: Shu Wang; Bradley Miller; Nirupa R Matthan; Zeynep Goktas; Dayong Wu; Debra B Reed; Xiangling Yin; Paula Grammas; Naima Moustaid-Moussa; Chwan-Li Shen; Alice H Lichtenstein Journal: Nutr Res Date: 2013-12 Impact factor: 3.315