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Non-alcoholic Fatty Liver Disease: A Clinical Update.

Authors
  • Pappachan, Joseph M1
  • Babu, Shithu2
  • Krishnan, Babu3
  • Ravindran, Nishal C4
  • 1 Department of Endocrinology, Diabetes & Metabolism, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Lancaster, UK.
  • 2 Department of Medicine, Dorset County Hospital, Dorchester, UK.
  • 3 Department of Gastroenterology & Hepatology, Royal Bournemouth Hospital, Bournemouth, UK.
  • 4 Department of Gastroenterology & Hepatology, Hinchingbrooke Hospital, Hinchingbrooke, Huntingdon, UK.
Type
Published Article
Journal
Journal of clinical and translational hepatology
Publication Date
Dec 28, 2017
Volume
5
Issue
4
Pages
384–393
Identifiers
DOI: 10.14218/JCTH.2017.00013
PMID: 29226105
Source
Medline
Keywords
License
Unknown

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.

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