Management of nonalcoholic fatty liver disease: An evidence-based clinical practice review

Arab, Juan Pablo; Cândia, Roberto; Zapata, Rodrigo; Muñoz, Cristián Pérez; Arancibia, Juan Pablo; Poníachik, Jaime; Soza, Alejandro; Fuster, Francisco; Brahm, Javier; Sanhueza, Edgar; Contreras, Jorge; Cuellar, ML; Arrese, Marco; Riquelme, Arnoldo

doi:10.3748/wjg.v20.i34.12182

Cited by 60 publications

(49 citation statements)

References 212 publications

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“…Data for Vitamin C and its effects on NAFLD shows no clear beneficial effects. The statement of the most recent consensus was that vitamin C is not recommended for patients with NAFLD outside the context of research protocols [66] .…”

Section: Vitamin Cmentioning

confidence: 99%

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Role of diet on non-alcoholic fatty liver disease: An updated narrative review

Papandreou

Andreou

2015

WJH

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The purpose of this article review is to update what is known about the role of diet on non-alcoholic fatty liver disease (NAFLD). NAFLD is the most common cause of chronic liver disease in the developed world and is considered to be a spectrum, ranging from fatty infiltration of the liver alone (steatosis), which may lead to fatty infiltration with inflammation known as non alcoholic steatohepatitis While the majority of individuals with risk factors like obesity and insulin resistance have steatosis, only few people may develop steatohepatitis. Current treatment relies on weight loss and exercise, although various insulin-sensitizing medications appear promising. Weight loss alone by dietary changes has been shown to lead to histological improvement in fatty liver making nutrition therapy to become a cornerstone of treatment for NAFLD. Supplementation of vitamin E, C and omega 3 fatty acids are under consideration with some conflicting data. Moreover, research has been showed that saturated fat, trans-fatty acid, carbohydrate, and simple sugars (fructose and sucrose) may play significant role in the intrahepatic fat accumulation. However, true associations with specific nutrients yet to be clarified.

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Section: Vitamin Cmentioning

confidence: 99%

“…Several concerns have been raised regarding an increase in allcause mortality with the long-term use of vitamin E [69] . Thus, the statement of the consensus was that the use of vitamin E is well supported for nondiabetic adults with biopsy-proven NASH [66] .…”

Section: Vitamin Ementioning

confidence: 99%

Role of diet on non-alcoholic fatty liver disease: An updated narrative review

Papandreou

Andreou

2015

WJH

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“…NASH-related LC, ≥50% linked with metabolic syndrome including obesity, hypertension, diabetes and high serum triglycerides, puts patients at increased risk for carotid and coronary atherosclerotic plaque formation [55][56][57][58].…”

Section: Cardiopulmonarymentioning

confidence: 99%

“…Increased risk for Atherosclerosis [55,56] Low-dose high-intensity statin [57,58] Atorvastatin No change in mortality Sodium restrict diet ≤ 2000 mg/day [73] Poor taste and ↓po → 5-6 g/d [71] Spironolactone 100 mg/d (400 mg/d max) +/-furosemide 40 mg/d (160 mg/d max) [1,73] Midodrine 7.5 mg q8 if refractory [48,73] LVP + albumin 6-8 g/L-removed if ≥5 L [73] SBP prophylaxis if appropriate (above)…”

Section: Introductionmentioning

confidence: 99%

Perioperative Risk Assessment and Management of Cirrhotic Patients

AL¹,

Dong²,

Nayi³

2015

J Hepatol Gastroint Dis

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Liver cirrhosis is an important risk factor for morbidity and mortality in any type of surgical procedure. For these patients, a distinct and tailored patient optimization approach prior to surgery is required in order to best risk mitigate towards avoiding decompensation and related complications, especially with the chronicity of this disease. This review is to enhance understanding of surgical risks in these patients in selecting patients for elective surgery, or managing those following emergency surgery.

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“…[1][2][3][4] Currently, NAFLD related chronic liver disease is the 3 rd leading indication for liver transplantation in the U.S. and is expected to be the leading cause in 2020. 2 Steatosis in NAFLD can progress to non-alcoholic steatohepatitis (NASH) with fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Non-alcoholic Fatty Liver Disease and the Gut Microbiota: Exploring the Connection

Oldfield¹,

Dong²,

Johnson³

2015

Gastro Open J

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As the gut microbiota continues to be implicated in an increasing number of disease processes, a plethora of new literature surrounding its complexity and role in the maintenance of intestinal homeostasis has become available. Non-alcoholic fatty liver disease (NAFLD) has become the most common nonviral liver disease worldwide and a number of predisposing risk factors for NAFLD have been identified, including obesity and insulin resistance. Recent evidence supports a role for the gut microbiota in the pathogenesis of these risk factors and NAFLD, itself. Additionally, changes in the gut microbiota can lead to activation of immune responses that have the potential to promote progression of NAFLD to the more severe Nonalcoholic steatohepatitis (NASH). Furthermore, the gut microbiota may serve as a potential target for therapeutic options to treat NAFLD. This review seeks to explain the role of the gut microbiota in the pathogenesis of NAFLD and its risk factors, while also discussing potential future treatment options directed at correcting imbalances with in the gut microbiota.

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Management of nonalcoholic fatty liver disease: An evidence-based clinical practice review

Abstract: Current NAFLD management is rapidly evolving, and new pathophysiology-based therapies are expected to be introduced in the near future. All NAFLD patients should be evaluated using a three-focused approach that considers the risks of liver disease, diabetes and cardiovascular events.

Cited by 60 publications

References 212 publications

Role of diet on non-alcoholic fatty liver disease: An updated narrative review

Role of diet on non-alcoholic fatty liver disease: An updated narrative review

Perioperative Risk Assessment and Management of Cirrhotic Patients

Non-alcoholic Fatty Liver Disease and the Gut Microbiota: Exploring the Connection

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