Nonalcoholic fatty liver disease: An overview of current insights in pathogenesis, diagnosis and treatment

Schreuder, Tim CMA; Verwer, Bart J.; Van Nieuwkerk, Carin M. J.; Mulder, Chris J. J.; Diamond, Deborah L.
April 2008
World Journal of Gastroenterology;4/28/2008, Vol. 14 Issue 16, p2474
Academic Journal
Estimates of people suffering from overweight (one billion) and obesity (300 million) are increasing. The accumulation of triglycerides in the liver, in the absence of excess alcohol intake, has been described in the early sixties. It was not until 1980, however, that Ludwig et al named this condition nonalcoholic steatohepatitis (NASH). Subsequently, nonalcoholic fatty liver disease (NAFLD) has been used as a general name for conditions ranging from simple steatosis through steatohepatitis to end-stage liver disease (cirrhosis). Many studies have demonstrated the significant correlation with obesity and insulin resistance. Other studies have revealed a significant correlation between hepatic steatosis, cardiovascular disease and increased intima-media thickness. WHO estimated that at least two million patients will develop cirrhosis due to hepatic steatosis in the years to come. Longitudinal cohort studies have demonstrated that those patients with cirrhosis have a similar risk to develop hepatocellular carcinoma as those with other causes of cirrhosis. Taken all together, NAFLD has become the third most important indication for liver transplantation. Therefore, training programmes in internal medicine, gastroenterology and hepatology should stress the importance of diagnosing this entity and treat properly those at risk for developing complications of portal hypertension and concomittant cardiovascular disease. This review will focus on the clinical characteristics, pathophysiology, imaging techniques and the readily available therapeutic options.


Related Articles

  • Morbid obesity exposes the association between PNPLA3 I148M (rs738409) and indices of hepatic injury in individuals of European descent. Romeo, S.; Sentinelli, F.; Dash, S.; Yeo, G. S. H.; Savage, D. B.; Leonetti, F.; Capoccia, D.; Incani, M.; Maglio, C.; Iacovino, M.; O'Rahilly, S.; Baroni, M. G. // International Journal of Obesity;Jan2010, Vol. 34 Issue 1, p190 

    Context:The PNPLA3 I148M variant (rs738409) is robustly associated with hepatic steatosis. Intriguingly, initial findings in cohorts with a mean body mass index (BMI) of 30 kg m−2 also suggested that it is associated with elevated liver enzymes but not with insulin resistance and...

  • Serum concentration of adiponectin, leptin and resistin in obese children with non-alcoholic fatty liver disease. Lebensztejn, D. M.; Wojtkowska, M.; Skiba, E.; Werpachowska, I.; Tobolczyk, J.; Kaczmarski, M. // Advances in Medical Sciences (De Gruyter Open);2009, Vol. 54 Issue 2, p177 

    Purpose: Obesity, insulin resistance and dyslipidemia are the most significant risk factors of non-alcoholic fatty liver disease (NAFLD) but the role of adipokines in patomechanism of this disease is not clear. The aim of the study was to evaluate the serum levels of leptin, adiponectin and...

  • Dietary Manipulation Alters the Phenotype of NAFLD in a Mouse Model - Implications for Human NASH. Subramanian, Savitha; Yeh, Matthew M.; Kowdley, Kris V.; Chait, Alan // Diabetes;Jun2007 Supplement 1, Vol. 56, pA456 

    Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. A "two-hit" hypothesis has been proposed for progression of a normal healthy liver to steatohepatitis (NASH), involving first the development of obesity and insulin resistance (IR) followed by...

  • Hepatocellular Carcinoma and Non-Alcoholic Fatty Liver Disease: From a Clinical to a Molecular Association. Petta, S.; Crax�, A. // Current Pharmaceutical Design;2/21/2010, Vol. 16 Issue 6, p741 

    Hepatocellular carcinoma (HCC) is the most frequent primary neoplasm of the liver, and is the fourth most common malignancy worldwide. It is also the third leading cause of cancer-related deaths. Most cases of HCC develop on a pre-existing chronic liver disease, usually due to hepatitis C virus...

  • Approach to the Pathogenesis and Treatment of Nonalcoholic Steatohepatitis. Medina, Jesús; Fernández-Salazar, Luis I.; García-Buey, Luisa; Moreno-Otero, Ricardo // Diabetes Care;Aug2004, Vol. 27 Issue 8, p2057 

    Nonalcoholic steatohepatitis (NASH) represents an advanced stage of fatty liver disease developed in the absence of alcohol abuse. Its increasing prevalence in western countries, the diagnostic difficulties by noninvasive tests, and the possibility of progression to advanced fibrosis and even...

  • Impact of Steatosis on Insulin Secretion in Chronic Hepatitis C Patients. Narita, Ryoichi; Abe, Shintaro; Tabaru, Akinari; Otsuki, Makoto // American Journal of Gastroenterology;Oct2007, Vol. 102 Issue 10, p2173 

    OBJECTIVES: Liver steatosis is frequently observed in patients with chronic hepatitis C (CHC) and is an identified risk factor for progression of liver fibrosis. This study aimed to evaluate the relationship between steatosis and host/viral factors, and the correlation between steatosis and...

  • Interrelationships between Hepatic Fat and Insulin Resistance in Non-Alcoholic Fatty Liver Disease. Lockman, Khalida A.; Nyirenda, Moffat J. // Current Diabetes Reviews;Sep2010, Vol. 6 Issue 5, p341 

    No abstract available.

  • Relationship Among Fatty Liver, Adipose Tissue Distribution and Metabolic Profile in Moderately Obese Children: An Ultrasonographic Study. Chiloiro, M.; Riezzo, G.; Chiarappa, S.; Correale, M.; Guerra, V.; Amati, L.; Noviello, M. R.; Jirillo, E. // Current Pharmaceutical Design;9/11/2008, Vol. 14 Issue 26, p2693 

    We examined the relationship between moderate obesity and glucose metabolism, insulin sensitivity and suspected fatty liver in children. We measured body mass index (BMI), z-score BMI, caliper skinfold thickness, waist and hip circumference in 94 participants (mean age 9.7 � 2.2 years)....

  • Nonalcoholic Fatty Liver Disease Associated with Obstructive Sleep Apnea: Just a Coincidence? Daltro, Carla; Cotrim, Helma P.; Alves, Erivaldo; De Freitas, Luiz António; Araújo, Leila; Boente, Leonardo; Leal, Rafael; Portugal, Thaís // Obesity Surgery;Nov2010, Vol. 20 Issue 11, p1536 

    Background: Obesity is associated with obstructive sleep apnea (OSA) and nonalcoholic fatty liver disease (NAFLD). It has been shown that OSA could be an independent risk factor for NAFLD. OSA could cause not only insulin resistance but worse NAFLD through nocturnal hypoxemia. This study aimed...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics