scholarly journals Non-alcoholic fatty liver disease as a medical and social problem

2021 ◽  
Vol 3 (2) ◽  
pp. 71-80
Author(s):  
Margarita E. Semendyaeva
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Fatty Liver ◽  
Social Problem ◽  
Fatty Liver Disease ◽  
Diagnosis And Treatment ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Steatohepatitis ◽  
Alcoholic Fatty Liver Disease

The article considers the non-alcoholic fatty liver disease as an important medical and social problem. This problem include such questions as metabolic syndrome, essential lipoproteinemia, insulinoresistance. It is possible to consider non-alcoholic steatohepatitis as predictor of liver fibrosis and chirrosis. The questions of diagnosis and treatment are discussed.

scholarly journals Metabolic syndrome and risk factors for non-alcoholic fatty liver disease

2012 ◽  
Vol 49 (1) ◽  
pp. 89-96 ◽  
Author(s):  
Mônica Rodrigues de Araújo Souza ◽  
Margareth de Fátima Formiga de Melo Diniz ◽  
José Eymard Moraes de Medeiros-Filho ◽  
Maria Salete Trigueiro de Araújo
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Experimental Studies ◽  
Final Analysis ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Steatohepatitis ◽  
Alcoholic Fatty Liver Disease

CONTEXT: Non-alcoholic fatty liver disease (NAFLD), hepatic manifestation of metabolic syndrome, has been considered the most common liver disease nowadays, which is also the most frequent cause of elevated transaminases and cryptogenic cirrhosis. The greatest input of fatty acids into the liver and consequent increased beta-oxidation contribute to the formation of free radicals, release of inflammatory cytokines and varying degrees of hepatocytic aggression, whose histological expression may vary from steatosis (HS) to non-alcoholic steatohepatitis (NASH). The differentiation of these forms is required by the potential risk of progression to cirrhosis and development of hepatocellular carcinoma. OBJECTIVE: To review the literature about the major risk factors for NAFLD in the context of metabolic syndrome, focusing on underlying mechanisms and prevention. METHOD: PubMed, MEDLINE and SciELO data basis analysis was performed to identify studies describing the link between risk factors for metabolic syndrome and NAFLD. A combination of descriptors was used, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, metabolic syndrome and risk factors. At the end, 96 clinical and experimental studies, cohorts, meta-analysis and systematic reviews of great impact and scientific relevance to the topic, were selected. RESULTS: The final analysis of all these data, pointed out the central obesity, type 2 diabetes, dyslipidemia and hypertension as the best risk factors related to NAFLD. However, other factors were highlighted, such as gender differences, ethnicity, genetic factors and the role of innate immunity system. How these additional factors may be involved in the installation, progression and disease prognosis is discussed. CONCLUSION: Risk factors for NAFLD in the context of metabolic syndrome expands the prospects to 1) recognize patients with metabolic syndrome at high risk for NAFLD, 2) elucidate pathways common to other co-morbidities, 3) determine risk factors associated with a worse prognosis, 4) develop therapeutic strategies with goal of reducing risk factors, 5) apply acquired knowledge in public health policies focusing on preventive strategies.

scholarly journals Drug Therapy for Non-Alcoholic Steatohepatitis-Induced Liver Fibrosis

2022 ◽  
Vol 31 (5) ◽  
pp. 16-24
Author(s):  
D. V. Garbuzenko
Keyword(s):  
Liver Disease ◽  
Drug Therapy ◽  
Liver Fibrosis ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Early Introduction ◽  
Alcoholic Steatohepatitis ◽  
Compensated Cirrhosis ◽  
Alcoholic Fatty Liver Disease

Aim. An overview of current pharmacotherapy for non-alcoholic steatohepatitis (NASH)-associated liver fibrosis.Key points. In current clinical recommendations, therapeutic measures in non-alcoholic fatty liver disease should include lifestyle change, body weight normalisation, NASH-associated liver fibrosis-specific drug therapy and treatment for metabolic syndrome-related diseases. Given a lack of approved antifibrotic therapies in NASH, several drugs have nevertheless demonstrated an adequate efficacy and safety in phase 3 clinical trials, also in compensated cirrhosis, which allows their practical validation in phase 4.Conclusion. The understanding of liver fibrosis as an adverse natural consequence of non-alcoholic fatty liver disease clearly attests for an early introduction and wide use of antifibrotic therapy to improve NASH outcomes and avoid associated complications. 

scholarly journals Comorbidity: non-alcoholic fatty liver disease and psoriasis

2021 ◽  
pp. 55-60
Author(s):  
O. B. Nemchaninova ◽  
E. Yu. Sklyanova ◽  
S. G. Lykova ◽  
E. N. Makhnovets ◽  
O. N. Pozdnyakova ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Multidisciplinary Approach ◽  
Diagnosis And Treatment ◽  
Alcoholic Fatty Liver ◽  
Psoriatic Disease ◽  
Close Relationship ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD), being a marker of significant changes in the hepatobiliary system against the background of metabolic syndrome and other endocrine pathologies, has a significant impact on the course of psoriatic disease. The presence of common mechanisms in the pathogenesis of these diseases suggests a very close relationship between them. This requires a multidisciplinary approach to studying the mechanisms of the pathogenesis of psoriasis and NAFLD, which will improve the methods of diagnosis and treatment of both diseases.

Non-alcoholic fatty liver disease and steatohepatitis

2013 ◽  
Vol 154 (29) ◽  
pp. 1124-1134
Author(s):  
Gabriella Pár ◽  
Gábor Horváth ◽  
Alajos Pár
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Treatment Modalities ◽  
High Dose ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Steatohepatitis ◽  
Increased Risk ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, the hepatic manifestations of metabolic syndrome with close association with inzulin resistance and obesity, are the most common liver diseases, affecting up to a third of the population worldwide. They confer increased risk for hepatocellular carcinoma as well as cardiovascular diseases. The review aims to summarize advances in epidemiology, pathogenesis and clinical management of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Besides liver biopsy and biomarkers, a novel non-invasive diagnostic tool the called “controlled attenuation parameter” measuring the attenuation of ultrasound generated by the transient elastography transducer, can quantitatively assess the hepatic fat content and differentiate between steatosis grades. At the same time, liver stiffness (fibrosis) can also be evaluated. The authors present their own results obtained with the latter procedure. In non-alcoholic fatty liver disease, the lifestyle intervention, weight loss, diet and exercise supported by cognitive behavioural therapy represent the basis of management. Components of metabolic syndrome (obesity, dyslipidaemia, diabetes and arterial hypertension) have to be treated. Although there is no approved pharmacological therapy for NASH, it seems that long lasting administration of vitamin E in association with high dose ursodeoxycholic acid may be beneficial. In addition, omega-3 polyunsaturated fatty acid substitution can also decrease liver fat, however, the optimal dose is not known yet. Further controlled clinical studies are warranted to establish the real value of any suggested treatment modalities for non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, although these are in experimental phase yet. Orv. Hetil., 2013, 154, 1124–1134.

scholarly journals Non-alcoholic fatty liver disease is associated with bacterial translocation and a higher inflammation response in psoriatic patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Isabel Belinchón-Romero ◽  
Pablo Bellot ◽  
David Romero-Pérez ◽  
Isolina Herraiz-Romero ◽  
Francisco Marco ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Bacterial Translocation ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Steatohepatitis ◽  
Tnf Α ◽  
Alcoholic Fatty Liver Disease

AbstractPsoriasis and non-alcoholic fatty liver disease (NAFLD) are both inflammatory diseases. The study objective was to estimate the risk of NAFLD, non-alcoholic steatohepatitis, and liver fibrosis (by liver stiffness and liver biopsy) in patients with psoriasis and to determine the epidemiological, clinical, immunological (TNF-α, IL-2, IL-6, IL-12, IL-17, IL-23, and TGF-β) characteristics, and bacterial translocation. Of the 215 psoriatic patients included, 91 presented NAFLD (prevalence: 42.3%). Compared to patients with psoriasis alone, those with NAFLD were significantly more likely to have metabolic syndrome, diabetes, dyslipidemia, body mass index ≥ 30 kg/m2, homeostatic model assessment of insulin resistance ≥ 2.15, and greater psoriasis area severity index. NAFLD patients also had significantly higher levels of TNF-α (p = 0.002) and TGF-β (p = 0.007) and a higher prevalence of bacterial translocation (29.7% vs. 13.7%; p = 0.004). Liver stiffness measurement was over 7.8 kPa in 17.2% (15/87) of NAFLD patients; 13 of these underwent liver biopsy, and 5.7% (5/87) had liver fibrosis, while 1.1% (1/87) had advanced fibrosis or non-alcoholic steatohepatitis. In conclusion the prevalence of NAFLD in patients with psoriasis is high and associated with a higher prevalence of metabolic syndrome features, bacterial translocation and a higher pro-inflammatory state. It is worth mentioning that liver fibrosis and non-alcoholic steatohepatitis are not frequent in this population of patients.

scholarly journals Συσχέτιση της μη αλκοολικής στεατοηπατίτιδας με την αρτηριακή σκληρία σε ασθενείς με μεταβολικό σύνδρομο πριν και μετά υπολιπιδαιμική αγωγή

2016 ◽  
Author(s):  
Κωνσταντίνος Καργιώτης
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Pulse Wave Velocity ◽  
Fatty Liver ◽  
Wave Velocity ◽  
Fatty Liver Disease ◽  
Pulse Wave ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Steatohepatitis ◽  
Alcoholic Fatty Liver Disease

Προς το παρόν δεν υπάρχει καμία αποτελεσματική θεραπεία για τη μη αλκοολική λιπώδη νόσο του ήπατος (Non Alcoholic Fatty Liver disease, NAFLD) ή την προχωρημένη μορφή της τη μη αλκοολική στεατοηπατίτιδα (Non Alcoholic Steatohepatitis, NASH), η οποία μπορεί να εξελίχθη σε κίρρωση του ήπατος και τελικά σε ηπάτωμα. Σκοπός της μελέτης ήταν να διερευνηθεί η επίδραση της ροσουβαστατίνης σε ασθενείς με μεταβολικό σύνδρομο (Metabolic Syndrome, MetS) και NASH. Καθώς και η πιθανή συσχέτιση των μεταβολών της NASH με τις μεταβολές της αρτηριακής σκληρίας μετά τη χορήγηση υπολιπιδαιμικής αγωγής. Η προοπτική αυτή μελέτη περιελάμβανε 20 ασθενείς με MetS, δυσλιπιδαιμία και αποδεδειγμένη με βιοψία NASH. Οι ασθενείς έλαβαν συμβουλές τρόπου ζωής και έλαβαν θεραπεία για 12 μήνες με ροσουβαστατίνη (10 mg/ημέρα) ως μονοθεραπεία. Επανάληψη βιοψίας και επανάληψη του υπερηχογραφήματος του ήπατος διεξήχθησαν στο τέλος της μελέτης σε όλους τους ασθενείς. Τα ηπατικά ένζυμα, η γλυκόζη πλάσματος νηστείας, τα επίπεδα του ουρικού οξέος, και το προφίλ των λιπιδίων αξιολογούνταν κάθε 3 μήνες. Το πρωτεύον καταληκτικό σημείο ήταν ο βαθμός υποστροφής της μη αλκοολικής στεατοηπατίτιδας σε συνδυασμό με την ελάττωση των τιμών της ταχύτητας του σφυγμικού κύματος (Pulse Wave Velocity, PWV). Η επαναληπτική βιοψία ήπατος και το επαναληπτικό υπερηχογράφημα έδειξε πλήρη υποστροφής της NASH σε 19 ασθενείς καθώς και σημαντική βελτίωση των τιμών της PWV σε διαδοχικές ανά εξάμηνο μετρήσεις. Ο 20ος ασθενής, ο οποίος δεν είχε καμία βελτίωση, αλλά ούτε επιδείνωση, εμφάνισε αρτηριακή υπέρταση και αύξηση των επιπέδων των τριγλυκεριδίων κατά τη διάρκεια της μελέτης, κατά πάσα πιθανότητα λόγω των αλλαγών στον τρόπο ζωής, συμπεριλαμβανομένης και της κατάχρησης αλκοόλ. Οι δραστηριότητες των ηπατικών ενζύμων του ορού αλανινική αμινοτρανσφεράση, ασπαρτική αμινοτρανσφεράση, γάμμα-γλουταμυλοτρανσπεπτιδάση και αλκαλική φωσφατάση ομαλοποιήθηκαν από τον 6ο μήνα της θεραπείας. Η γλυκόζη νηστείας του πλάσματος και η τιμή της γλυκοζυλιωμένης αιμοσφαιρίνης μειώθηκαν στατιστικά. Οι τιμές των λιπιδίων ομαλοποιήθηκαν από τον 3ο μήνα της θεραπείας. Κανένας ασθενής δεν είχε MetS από τον 9ο μήνα της θεραπείας. Ο δείκτης μάζας σώματος και η περίμετρος της μέσης παρέμειναν αμετάβλητες κατά τη διάρκεια της μελέτης. Έτσι, οι μεταβολές στην ηπατική παθολογία και λειτουργία θα πρέπει να αποδοθούν αποκλειστικά στη μονοθεραπεία με ροσουβαστατίνη. Τα ευρήματα αυτά υποδηλώνουν ότι η μονοθεραπεία με ροσουβαστατίνη θα μπορούσε να βελτιώσει την αποδεδειγμένη με βιοψία στεατοηπατίτιδα με παράλληλη ευνοϊκή επίδραση της αρτηριακής σκληρίας και να προκαλέσει σημαντική βελτίωση των παραμέτρων του MetS εντός 12 μηνών. Αυτές οι επιδράσεις αλλά και η μείωση της γλυκόζης νηστείας του πλάσματος και των επιπέδων ουρικού οξέος στον ορό μπορεί να μειώσουν σημαντικά τον κίνδυνο της σχετιζόμενης με το καρδιαγγειακό σύστημα, αλλά και με το ήπαρ, νοσηρότητας και θνησιμότητας σε ασθενείς με μη αλκοολική στεατοηπατίτιδα. Αυτά τα ευρήματα χρειάζονται επιβεβαίωση από μεγαλύτερες μελέτες.

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