Metabolic Syndrome and NASH

Marchesini, Giulio; Marzocchi, Rebecca

doi:10.1016/j.cld.2007.02.013

Cited by 120 publications

(81 citation statements)

References 67 publications

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“…NASH is considered by many to be a component of the metabolic syndrome, a cluster of closely associated abnormalities related to insulin resistance [Marchesini and Marzocchi, 2007]. Lifestyle intervention, metformin, and the TZDs can help prevent the progression of glucose intolerance and the onset of type 2 diabetes [Gerstein et al 2006;Knowler et al 2002;Tuomilehto et al 2001].…”

Section: The Nonalcoholic Steatohepatitis Clinicalmentioning

confidence: 99%

The role of insulin-sensitizing agents in the treatment of nonalcoholic steatohepatitis

Wagner

Rinella

2011

Therap Adv Gastroenterol

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Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome, which includes dyslipidemia, central obesity, hypertension, and insulin resistance. These diseases collectively and individually increase the risk of cardiovascular disease. Nonalcoholic steatohepatitis (NASH) is a subset of NAFLD that can progress to cirrhosis in up to 30% of patients and lead to decompensated liver disease requiring liver transplantation in many patients. Insulin resistance is the pathophysiological hallmark of NASH and addressing insulin resistance is an important aspect of NASH management. Lifestyle modifications with diet and exercise improve insulin sensitivity and are the cornerstone of therapy, but are often difficult to maintain long term. Not surprisingly, insulin-sensitizing agents have been a focus of pharmacologic investigation in NASH. Insulin sensitizers such as the thiazolidinediones, biguanides, glucagon-like peptide-1 receptor agonists, and the dipeptidyl peptidase IV inhibitors, also known as incretins, will be discussed with respect to their mechanism of action and how these drugs might target aspects of NASH pathophysiology. Finally, we will summarize the available clinical data and review both the risks and benefits of insulin sensitizers in the treatment of NASH.

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Section: The Nonalcoholic Steatohepatitis Clinicalmentioning

confidence: 99%

The role of insulin-sensitizing agents in the treatment of nonalcoholic steatohepatitis

Wagner

Rinella

2011

Therap Adv Gastroenterol

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“…6 Finally, it has been shown that the majority of fibrosis progression occurred in patients aged 50 years or older. 7 In conclusion, on the basis of the majority of studies concerning the long-term outcome of HCV infection in children 1,2 and adults, [3][4][5][6][7] we think that the conclusive sentence of Goodman that chronically HCVinfected children will be at risk for end-stage liver disease as adults is not adequately supported by results observed so far. …”

mentioning

confidence: 58%

“…3,4 In another study regarding adults infected as young military recruits, the frequency of cirrhosis after 50 years was only 6%. 5 No linear correlation was found between duration and severity of disease. 5 Furthermore, it seems that higher degrees of fibrosis were related with age at infection being more frequent in patients Ն65 years regardless the duration of infection.…”

mentioning

confidence: 85%

“…5 No linear correlation was found between duration and severity of disease. 5 Furthermore, it seems that higher degrees of fibrosis were related with age at infection being more frequent in patients Ն65 years regardless the duration of infection. 6 Finally, it has been shown that the majority of fibrosis progression occurred in patients aged 50 years or older.…”

mentioning

confidence: 85%

“…Furthermore, in practice, it would be quite difficult to include such control groups of meaningful size for the following reasons: (1) nonobese patients with IR and NAFLD are relatively uncommon and (2) patients with IR without NAFLD frequently lack histological confirmation. 4,5 Indeed, reduced lean mass, small cross-sectional muscle fiber area, and increased triglyceride deposition in skeletal muscle in conjunction with dysfunctional/reduced lipolysis can result in reduced cardiorespiratory fitness. However, it is unknown whether these adaptations take place as a result of reduced physical activity, NAFLD, or both.…”

Section: Melania Manco MD Phd 1 Valerio Nobili Md 2 1 Scientmentioning

confidence: 99%

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