Nonalcoholic Steatohepatitis: A Review of the Literature and Updates in Management

Pasumarthy, Lakshmi; Srour, James

doi:10.1097/smj.0b013e3181de0ce0

Cited by 14 publications

(10 citation statements)

References 34 publications

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“…It is reported that almost 10% ~ 20% of individuals with NAFLD have NASH, 10% ~ 15% of individuals with NASH progress to cirrhosis [14]. In patients with cirrhotic NASH, HCC and liver failure are the main causes of morbidity and mortality (5-year cumulative HCC development rate 11.3%, 5-year survival rate 75.2%, respectively) [15].…”

Section: Backgroundsmentioning

confidence: 99%

Prevalence and factors associated with nonalcoholic fatty liver disease in shanghai work-units

Huang

Bao

et al. 2012

BMC Gastroenterol

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BackgroundsNonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in Asians. However, data on prevalence and factors associated with NAFLD in Asians are lacking. The aim of this study is to investigate the prevalence of NAFLD in Shanghai employees to assess the relationship between NAFLD and age, gender, metabolic risk factors in this studied population.MethodsWe selected 7152 employees of Shanghai work-units. Each of them underwent detailed medical history-taking, physical examination, laboratory assessments and abdominal ultrasonography. The diagnosis of NAFLD was done according to established criteria. Receiver operating characteristics (ROC) curves were applied to detect areas under the ROC curves for each index. Nominal logistic regression analysis was used to estimate the odds ratio for risk factors of NAFLD.ResultsAbout 38.17% employees had NAFLD, more in men than in women. The prevalence of NAFLD increased with increasing age. In both genders, the prevalence of metabolic factors was higher in the NAFLD group. Body max index, waist circumference, weight-to-height ratio, blood pressure, blood glucose, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein and uric acid were found to have a diagnostic value for NAFLD. Body max index is a better index for diagnosing NAFLD. Uric acid is a new diagnosing index not inferior to lipid metabolic factors. Metabolic factors can increase the risk of NAFLD up to 1.5 ~ 3.8 times.ConclusionsOlder age, male gender, metabolic factors such as obesity, abdominal obesity, dyslipidemia, hypertension or type 2 diabetes are risk factors for NAFLD. Prevalence of NAFLD in Shanghai employees is high. Prevention is extremely important. Those achieve the critical point should have early intervention.

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Section: Backgroundsmentioning

confidence: 99%

Prevalence and factors associated with nonalcoholic fatty liver disease in shanghai work-units

Huang

Bao

et al. 2012

BMC Gastroenterol

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“…Other treatment approaches include special diets, antioxidants, and cytoprotective therapy [ 3 ]. In the 1990s, the incidence of NAFLD and NASH began to increase in both adults and children, in parallel with the rise in obesity rates, and are now widely recognized pathological conditions [ 4 ]. The estimated prevalence rates of NAFLD and NASH are 20–30 and 3.5–5 %, respectively [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with NASH, moreover, have reduced survival rates [ 6 ]. As the prevalence of NASH threatens to increase further, many medications are being evaluated, targeting different steps in the development of hepatic steatosis or its progression to steatohepatitis [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

In Vivo Efficacy Study of Milk Thistle Extract (ETHIS-094™) in STAM™ Model of Nonalcoholic Steatohepatitis

Pais¹,

D’Amato²

2014

Drugs R D

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IntroductionA subcategory of nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH) is characterized by accumulation of fat accompanied by inflammatory infiltration and hepatocellular damage. The active complex of milk thistle is a lipophilic extract from its seeds, comprising three isomers, collectively known as silymarin. Silymarin has demonstrated antioxidant, anti-inflammatory, and antifibrotic properties, and has been extensively studied in the treatment of liver diseases. The majority of published clinical research on silymarin has used Legalon® (Rottapharm/Madaus), containing the patented extract of milk thistle ETHIS-094™ (Euromed). The current study was undertaken to examine the effects of ETHIS-094™ in the Stelic Animal Model (STAM™), a validated and widely used animal model for NASH.MethodsAfter 4 h fasting from 4 to 8 weeks of age, 15 male mice in whom NASH had been induced were orally administered, once daily, either (1) vehicle (saline) at a volume of 10 mL/kg, (2) vehicle supplemented with milk thistle at a dose of 500 mg/kg, or (3) vehicle supplemented with milk thistle at a dose of 1,000 mg/kg.ResultsMean liver weight and the liver-to-body weight ratio were significantly (P < 0.01) decreased in the milk thistle high-dose group compared with the vehicle group. NAFLD activity score (NAS) tended to decrease in the milk thistle treatment groups compared with vehicle group, as did steatosis scores.ConclusionMilk thistle extract administration induced a decreasing trend in NAS compared with the vehicle group. Milk thistle induced a numerical decrease of the steatosis score compared with vehicle, and this was accompanied by a statistically significant decrease in liver weight and the liver-to-body weight ratio, implying a potential anti-steatosis effect of milk thistle.Electronic supplementary materialThe online version of this article (doi:10.1007/s40268-014-0068-2) contains supplementary material, which is available to authorized users.

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“…Due to an increased average life span, present generations of women can expect to spend at least a third of their lives in the postmenopausal state [4]. Dietary and lifestyle guidelines to reduce overall body weight may help avoid NAFLD, however, there are no specific drugs to treat this liver disease [5].…”

Section: Introductionmentioning

confidence: 99%

Protective Effects of White Button Mushroom (Agaricus bisporus) against Hepatic Steatosis in Ovariectomized Mice as a Model of Postmenopausal Women

et al. 2011

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Nonalcoholic fatty liver disease (NAFLD) includes various hepatic pathologies ranging from hepatic steatosis to non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis. Estrogen provides a protective effect on the development of NAFLD in women. Therefore, postmenopausal women have a higher risk of developing NAFLD. Hepatic steatosis is an early stage of fatty liver disease. Steatosis can develop to the aggressive stages (nonalcoholic steatohepatitis, fibrosis and cirrhosis). Currently, there is no specific drug to prevent/treat these liver diseases. In this study, we found that white button mushroom (WBM), Agaricus Bisporus, has protective effects against liver steatosis in ovariectomized (OVX) mice (a model of postmenopausal women). OVX mice were fed a high fat diet supplemented with WBM powder. We found that dietary WBM intake significantly lowered liver weight and hepatic injury markers in OVX mice. Pathological examination of liver tissue showed less fat accumulation in the livers of mice on WBM diet; moreover, these animals had improved glucose clearance ability. Microarray analysis revealed that genes related to the fatty acid biosynthesis pathway, particularly the genes for fatty acid synthetase (Fas) and fatty acid elongase 6 (Elovl6), were down-regulated in the liver of mushroom-fed mice. In vitro mechanistic studies using the HepG2 cell line showed that down-regulation of the expression of FAS and ELOVL6 by WBM extract was through inhibition of Liver X receptor (LXR) signaling and its downstream transcriptional factor SREBP1c. These results suggest that WBM is protective against hepatic steatosis and NAFLD in OVX mice as a model for postmenopausal women.

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Nonalcoholic Steatohepatitis: A Review of the Literature and Updates in Management

Cited by 14 publications

References 34 publications

Prevalence and factors associated with nonalcoholic fatty liver disease in shanghai work-units

Prevalence and factors associated with nonalcoholic fatty liver disease in shanghai work-units

In Vivo Efficacy Study of Milk Thistle Extract (ETHIS-094™) in STAM™ Model of Nonalcoholic Steatohepatitis

Protective Effects of White Button Mushroom (Agaricus bisporus) against Hepatic Steatosis in Ovariectomized Mice as a Model of Postmenopausal Women

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