Non-alcoholic fatty liver disease medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
There is no standard treatment for non-alcoholic fatty liver disease;the mainstay of therapy is dietary and life style modifications | There is no standard treatment for the non-alcoholic fatty liver disease;the mainstay of therapy is dietary and life style modifications which include improving metabolic risk factors -[[weight loss]], treating [[diabetes]], managing [[lipids]] and reducing [[alcohol]] intake. | ||
==Medical Therapy== | ==Medical Therapy== | ||
Revision as of 21:31, 19 December 2017
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Non-Alcoholic Fatty Liver Disease Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
There is no standard treatment for the non-alcoholic fatty liver disease;the mainstay of therapy is dietary and life style modifications which include improving metabolic risk factors -weight loss, treating diabetes, managing lipids and reducing alcohol intake.
Medical Therapy
- There is no one FDA approved specific treatment for NAFLD. Multiple trails are going on to obtain specific and effective treatment for NAFLD.
- One of the largest trials of NAFLD/NASH therapy evaluated rosiglitazone, an insulin-sensitizing thiazolidinedione.[1].
- Rosiglitazone is recommended among all patients who develop NAFLD. Long term treatment with rosiglitazone in patients with NAFLD shows significant improvement.[2]
- Rosiglitazone 4 mg PO/OD for 6 months.[3]
- Patients with NAFLD shows benifits when using ursodeoxycholic acid (UDCA) in combination with vitamin E improved laboratory values and hepatic steatosis of patients with NASH.[4]
- Pharmacologic medical therapies for NAFLD also include vitamin E with vitamin C which shows statstically significant improvement without any side effects in fibrosis score (p=0.002).[5]
- Avoid high dose of vitamin E which increases the fatality rate.Vitamin E (RRR-α-tocopherol) at a dose of 800 IU/day is best advocated in non-diabetic and non-cirrhotic adults with lively NASH on histology.
- Moringa Oleifera (MO), a plant from the family Moringacea is a major crop in Asia and Africa, the leaves of these plant have been studied extensively and it has shown to be beneficial in NAFLD and in prevention and alleviation of NAFLD.[8]
References
- ↑ Ratziu V, Giral P, Jacqueminet S, Charlotte F, Hartemann-Heurtier A, Serfaty L, Podevin P, Lacorte JM, Bernhardt C, Bruckert E, Grimaldi A, Poynard T (2008). "Rosiglitazone for nonalcoholic steatohepatitis: one-year results of the randomized placebo-controlled Fatty Liver Improvement with Rosiglitazone Therapy (FLIRT) Trial". Gastroenterology. 135 (1): 100–10. doi:10.1053/j.gastro.2008.03.078. PMID 18503774.
- ↑ "Long-term efficacy of rosiglitazone in nonalcoholic steatohepatitis: Results of the fatty liver improvement by rosiglitazone therapy (FLIRT 2) extension trial - Ratziu - 2009 - Hepatology - Wiley Online Library".
- ↑ Saryusz-Wolska M, Szymańska-Garbacz E, Jabłkowski M, Białkowska J, Pawłowski M, Kwiecińska E, Omulecka A, Borkowska A, Ignaczak A, Loba J, Czupryniak L (2011). "Rosiglitazone treatment in nondiabetic subjects with nonalcoholic fatty liver disease". Pol. Arch. Med. Wewn. 121 (3): 61–6. PMID 21430606.
- ↑ Dufour JF, Oneta CM, Gonvers JJ, Bihl F, Cerny A, Cereda JM, Zala JF, Helbling B, Steuerwald M, Zimmermann A (2006). "Randomized placebo-controlled trial of ursodeoxycholic acid with vitamin e in nonalcoholic steatohepatitis". Clin. Gastroenterol. Hepatol. 4 (12): 1537–43. doi:10.1016/j.cgh.2006.09.025. PMID 17162245.
- ↑ Harrison SA, Torgerson S, Hayashi P, Ward J, Schenker S (2003). "Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis". Am. J. Gastroenterol. 98 (11): 2485–90. doi:10.1111/j.1572-0241.2003.08699.x. PMID 14638353.
- ↑ Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E (2005). "Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality". Ann. Intern. Med. 142 (1): 37–46. PMID 15537682.
- ↑ Busciglio J, Lorenzo A, Yankner BA (1992). "Methodological variables in the assessment of beta amyloid neurotoxicity". Neurobiol. Aging. 13 (5): 609–12. PMID 1461350.
- ↑ "pdfs.semanticscholar.org" (PDF).