Update on current standards of care in the diagnosis and management of Non-Alcoholic Fatty Liver Disease (NAFLD) and non-alcoholic steatohepatitis (NASH)

Diagnosis. Part 1

Perry Hookman, Jamie S Barkin

Research output: Contribution to journalArticle

Abstract

Steatosis (fatty infiltration of the liver) or Non-Alcoholic Fatty Liver Disease (NAFLD) is increasingly recognized as a ubiquitous cause of chronic liver disease. It represents a spectrum of fatty liver without inflammation to steatosis accompanied by inflammation, and fibrosis [NASH]. NAFLD/NASH is associated with obesity, hypertension hyperlipidemia, diabetes mellitus and insulin resistance-disorders collectively known as the Metabolic Syndrome. NAFLD is potentially progressive and may lead to NASH (non-alcoholic steatohepatitis) which is a chronic disease characterized by diffuse fatty infiltration, lobular inflammation, with or without perisinusoidal fibrosis. NASH can lead to cirrhosis and end stage liver disease ultimately requiring liver transplantation. NASH can be silent without any physical symptoms or lab abnormalities and be associated with end stage "cryptogenic" cirrhosis as well as hepatic cancer. For that reason physicians must be more alert in recognizing the clinical features of NASH so that earlier diagnosis, treatment and at least monitoring, can be initiated. Previous published articles dealing with the medical treatment of NAFLD/NASH mostly include drug studies that have been open labeled, and not double blind placebo controlled studies. There is still no evidence-based definitive medical treatment of NASH. However there is promising data on some therapeutic measures. This article will objectively review what we know of the recommendations and the standard of care in the medical treatment of NAFLD/NASH.

Original languageEnglish
Pages (from-to)70-88
Number of pages19
JournalPractical Gastroenterology
Volume28
Issue number9
StatePublished - Sep 1 2004

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Fatty Liver
Standard of Care
Fibrosis
Inflammation
Non-alcoholic Fatty Liver Disease
Chronic Disease
Therapeutics
End Stage Liver Disease
Liver Neoplasms
Hyperlipidemias
Liver Transplantation
Insulin Resistance
Liver Diseases
Early Diagnosis
Diabetes Mellitus
Obesity
Placebos
Hypertension
Physicians

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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abstract = "Steatosis (fatty infiltration of the liver) or Non-Alcoholic Fatty Liver Disease (NAFLD) is increasingly recognized as a ubiquitous cause of chronic liver disease. It represents a spectrum of fatty liver without inflammation to steatosis accompanied by inflammation, and fibrosis [NASH]. NAFLD/NASH is associated with obesity, hypertension hyperlipidemia, diabetes mellitus and insulin resistance-disorders collectively known as the Metabolic Syndrome. NAFLD is potentially progressive and may lead to NASH (non-alcoholic steatohepatitis) which is a chronic disease characterized by diffuse fatty infiltration, lobular inflammation, with or without perisinusoidal fibrosis. NASH can lead to cirrhosis and end stage liver disease ultimately requiring liver transplantation. NASH can be silent without any physical symptoms or lab abnormalities and be associated with end stage {"}cryptogenic{"} cirrhosis as well as hepatic cancer. For that reason physicians must be more alert in recognizing the clinical features of NASH so that earlier diagnosis, treatment and at least monitoring, can be initiated. Previous published articles dealing with the medical treatment of NAFLD/NASH mostly include drug studies that have been open labeled, and not double blind placebo controlled studies. There is still no evidence-based definitive medical treatment of NASH. However there is promising data on some therapeutic measures. This article will objectively review what we know of the recommendations and the standard of care in the medical treatment of NAFLD/NASH.",
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