Emerging New Diagnostic Modalities and Therapies of Nonalcoholic Fatty Liver Disease

Lin, Chuan-Hao; Kohli, Rohit

doi:10.1007/s11894-020-00786-y

Cited by 9 publications

(9 citation statements)

References 35 publications

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“… [52] The Food and Drug Administration did not support the accelerated approval of obeticholic acid for NASH treatment of patients because its expected benefits based on histopathological endpoints are still uncertain, and the benefits of treatment have not exceeded the potential adverse effect risks. [53] Its histopathological result was still superior among the novel metabolic agents and natural plant drugs in this analysis. However, obeticholic acid showed serious adverse effects of increasing LDL-C levels and decreasing HDL-C levels, which will increase the risk of cardiovascular disease and all-cause mortality.…”

Section: Discussionmentioning

confidence: 85%

The efficacy of novel metabolic targeted agents and natural plant drugs for nonalcoholic fatty liver disease treatment

Zhou

Chen

et al. 2021

Medicine

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Background: Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent chronic liver disease characterized by excess accumulation of fat in hepatocytes. Because no drug has been approved for NAFLD treatment, this work analyzed the effects of agents resulting from 2 research hotspots, metabolic target agents, and natural plant drugs, on NAFLD with network meta-analysis. Methods: Public databases were searched through August 14, 2020. Randomized controlled trials that compared obeticholic acid, elafibranor, cenicriviroc, selonsertib, curcumin, silymarin, and resveratrol to placebo were included. Liver pathology improvement, hepatic biochemical indicators, and lipid metabolism indicators were analyzed. Results: Thirty-five studies were included in the meta-analysis. Obeticholic acid was found to significantly increase the frequency of liver biopsy improvement compared to placebo (OR: 2.10; 95% CI: 1.60, 2.77). The ranking results among the hepatic biochemical indicators showed that obeticholic acid (94.9%) and elafibranor (86.3%) have a relative advantage in reducing alanine aminotransferase (ALT) levels, and obeticholic acid also had an advantage (95.4%) in reducing aspartate aminotransferase (AST) levels. Considering lipid metabolic indicators, elafibranor (expSMD: 0.01; 95% CI: 0.00, 0.05; SUCRA: 100%), and obeticholic acid (expSMD: 0.48; 95% CI: 0.28,0.84; SUCRA: 75.6%) significantly reduced triglyceride (TG) levels compared with placebo; moreover, obeticholic acid, but not elafibranor, caused a serious increase in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels and a decrease in high-density lipoprotein cholesterol (HDL-C) levels. Conclusions: Novel metabolic targeted agents generally have better effects than natural plant drugs, especially obeticholic acid, and elafibranor. However, obeticholic acid showed serious adverse effects such as increasing LDL-C levels and decreasing HDL-C levels. Curcumin showed potential advantages for NAFLD but lacked statistical significance.

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Section: Discussionmentioning

confidence: 85%

The efficacy of novel metabolic targeted agents and natural plant drugs for nonalcoholic fatty liver disease treatment

Zhou

Chen

et al. 2021

Medicine

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“…9 There is greater diagnostic value in the application of MRI-PDFF and liver elastography because they F I G U R E 5 Receiver operating characteristic (ROC) curves of controlled attenuation parameter (CAP) in S3 group can grade the degree of liver fibrosis and steatosis, and these procedures are expected to replace liver biopsy puncture. [13][14][15] Liver elastography and MRI-PDFF are currently of great interest in the field of pediatric NAFLD due to their non-invasive nature and high diagnostic efficacy. 16,17 The application of MRI-PDFF is relatively expensive, which may be a barrier for developing countries with large populations.…”

Section: Discussionmentioning

confidence: 99%

Controlled attenuation parameter in the diagnosis of different liver steatosis groups in children with obesity

Yang

Zhu

et al. 2022

Pediatric Obesity

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Objective: To investigate the utility of the controlled attenuation parameter (CAP), as measured by a liver elastography technique, in predicting varying degrees of liver steatosis in children with obesity.Methods: Children with obesity attending the pediatric obesity clinic at the Affiliated Hospital of Hangzhou Normal University from July 2020 to May 2021 were retrospectively analysed. The 71 subjects were divided into four groups according to the degree of liver steatosis obtained by magnetic resonance imaging-proton density fat fraction (MRI-PDFF). The gender, age, CAP, LSM, ALT, AST, BMI, uric acid, fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, insulin, and blood 25-hydroxyvitamin D levels of the four groups were compared, and the differences were analysed. Clinical data with significant differences were included in the logistic regression analysis.The receiver operating characteristic (ROC) curve for the CAP for the 71 subjects with different degrees of liver steatosis was plotted to evaluate the diagnostic value.Results: The 71 children were divided into groups according to the degree of hepatic steatosis obtained by MRI-PDFF, and the clinical data for each group were compared. It was found that there was statistical significance for CAP, ALT, and AST in cases of moderate and severe hepatic steatosis (p < 0.05). Logistic regression analysis was conducted between CAP, ALT, AST, and moderate to severe hepatic steatosis in children with obesity, and it was found that CAP was a factor related to moderate to severe hepatic steatosis in children with obesity.The ROC curve indicated that CAP has diagnostic value for NAFLD in children with obesity. Conclusion:There is diagnostic value in the use of CAP for hepatic steatosis in children with obesity, and there is greater diagnostic value in the use of CAP for children with moderate to severe hepatic steatosis.

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“…This review classifies and sorts out the relevant clinical research data in the early stage, and compares the research results of patients with and without diabetes, adults and children. It was concluded that metformin in the treatment of nonalcoholic fatty liver disease, higher dose may be more likely to cause weight loss, reduce insulin resistance, and thus improve liver histology [27][28]. Two studies using higher doses of metformin did find significant weight loss [20][21].…”

Section: Discussionmentioning

confidence: 99%

Research Progress of Metformin in the Treatment of Non-alcoholic Fatty Liver Disease

Liu¹,

Xie²

2020

ABB

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Backgroud: Nonalcoholic fatty liver disease has become the second largest source of chronic liver disease in the urban population. Metformin, a traditional drug, has good prospects for treating the disease in primary health care facilities. Objective: To summarize and grasp the status of metformin in adults, children with diabetes and non-diabetic NAFLD patients. Methods: We reviewed 31 relevant research literatures in PubMed database, and sorted out some preclinical and clinical research results. Results: Metformin was found to have a good effect in improving liver function indicators in both adult diabetic and non-diabetic NAFLD patients, and could benefit liver histology in NAFLD patients with adult diabetes. Metformin treatment did not show a significant advantage over lifestyle interventions in children with NAFLD. Conclusion: Metformin can improve the liver function and histological structure of adult NAFLD patients to a certain extent, and children patients should still be treated mainly with improved lifestyle.

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Emerging New Diagnostic Modalities and Therapies of Nonalcoholic Fatty Liver Disease

Cited by 9 publications

References 35 publications

The efficacy of novel metabolic targeted agents and natural plant drugs for nonalcoholic fatty liver disease treatment

The efficacy of novel metabolic targeted agents and natural plant drugs for nonalcoholic fatty liver disease treatment

Controlled attenuation parameter in the diagnosis of different liver steatosis groups in children with obesity

Research Progress of Metformin in the Treatment of Non-alcoholic Fatty Liver Disease

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