Review: Current status of therapy in nonalcoholic fatty liver disease

Abstract

Abstract:The obesity epidemic has now spread worldwide. With increase in weight, there is an increase in dysregulated energy metabolism ultimately leading to dysfunction of multiple organ systems recognized as the metabolic syndrome. Nonalcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease worldwide, and is thought to be the hepatic manifestation of metabolic syndrome. It is a nondiscriminating disease affecting both children and adults and no socioeconomic class is spared. There is a well-defined increase in both liver-related and all-cause mortality. Current projections foresee a continued worsening in prevalence, especially with the increased rate of childhood obesity. Prevention would be the ultimate goal, but with continued trends in obesity, therapeutic options are needed to manage this chronic liver disease and prevent its complications of cirrhosis and even hepatocellular carcinoma. Therapies will need to be affordable, tolerable, and safe to be useful on such a large scale. This article will discuss some of the basic understanding of NAFLD, as well as review the currently tested therapies, some novel therapies, and potential future therapeutic options.

Potential involvement of PPAR α activation in diminishing the hepatoprotective effect of fenofibrate in NAFLD

“…GF has been evaluated in one controlled trial that included 46 patients with NASH. After 4 weeks of therapy, there was a significant decline in liver enzymes and improvement in liver function [42].…”

Nonalcoholic Fatty Liver Disease: A Review and Update

“…However, careful analysis of the potential risks associated with thiazolidinediones must be considered prior to administering this medication. One recent review suggests that patients receiving thiazolidinedione therapy be treated for a minimum of 12 months [162]. This group of patients may show benefit via a reduction in LFTs and improvement in liver histology.…”

Non-Alcoholic Fatty Liver Disease: The Effect of Bile Acids and Farnesoid X Receptor Agonists on Pathophysiology and Treatment

“…30 The incidence is significantly increased in diabetics (up to 63%) and in the morbidly obese. 31 Given the epidemic of obesity attributable to the content of fat in modern diet, it is estimated that 42 million children were obese in 2010 and this figure is expected to rise to almost 60 million by 2020. 32 These projections foresee a continued worsening trend in obesity and chronic liver disease, thus alternative therapeutic options are needed.…”