EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease

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doi:10.1159/000443344

Cited by 402 publications

(221 citation statements)

References 149 publications

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“…Hypertension was defined as blood pressure ≥140/90 mm Hg or the use of any antihypertensive drug [17]. Non-alcoholic fatty liver disease was diagnosed by abdominal ultrasound [18]. Obstructive sleep apnea syndrome was diagnosed according to the results of a nocturnal instrumental registration of the breathing pattern during sleep and standardized diagnostic criteria [19].…”

Section: Methodsmentioning

confidence: 99%

Effects of an Intensive Inpatient Rehabilitation Program in Elderly Patients with Obesity

et al. 2019

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Objective: The aim of this study was to assess the short-term effectiveness of an intensive inpatient multidimensional rehabilitation program (MRP), including diet, exercise, and behavioral therapy, in elderly patients with severe obesity. Methods: Forty-four elderly patients (old; age 69.3 ± 3.5 years, BMI 41.9 ± 14.9) were analyzed against 215 younger patients (young; age 48.2 ± 18.5 years, BMI 43.9 ± 9.4), who were used as controls. All patients underwent MRP, based on group therapy guided by a multidisciplinary team (physicians, dietitians, exercise trainers, psychologists). We evaluated changes in anthropometry, cardiovascular risk factors, physical fitness, quality of life, and eating behavior. Results: After 3 weeks of MRP, we observed a reduction in body weight (old –3.8%, young –4.3%), BMI (old –3.9%, young –4.4%), waist circumference (old –3.4%, young –4.1%), total cholesterol (old –14.0%, young –15.0%), and fasting glucose (old –8.3%, young –8.1%), as well as improved performance in the Six-Minute-Walk Test (old +28.7%, young +15.3%), chair-stand test (old +24.8%, young +26.9%), and arm-curl test (old +15.2%, young +27.3%). Significant improvement was registered in all other analyzed domains. Conclusion: Our 3-week MRP provided significant clinical and functional improvement, which was similar between elderly and younger patients with severe obesity. In the long-term, this may be translated into better quality of life, through better management of obesity-associated morbidities and reduced frailty.

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Section: Methodsmentioning

confidence: 99%

Effects of an Intensive Inpatient Rehabilitation Program in Elderly Patients with Obesity

et al. 2019

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“…Non-alcoholic fatty liver disease (NAFLD) is an obesity-related disease that is both a complication of and a risk factor for type 2 diabetes [1][2][3]. Traditionally, thiazolidinediones (TZDs) are the first-line treatment for patients with comorbid T2D and NAFLD [4]. TZDs are peroxisome proliferator-activated receptor gamma agonists that improve glucose tolerance and insulin sensitivity and enhance insulin action in the muscle, liver, and heart as well as in adipose tissue [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Ipragliflozin Additively Ameliorates Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Controlled with Metformin and Pioglitazone: A 24-Week Randomized Controlled Trial

Han

Lee

et al. 2020

JCM

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Despite the benefits of pioglitazone in the treatment of non-alcoholic fatty liver disease (NAFLD), many treated patients continue to experience disease progression. We aimed to investigate the additive effect of ipragliflozin on NAFLD in patients with type 2 diabetes treated with metformin and pioglitazone. In this 24-week randomized controlled trial, 44 patients with type 2 diabetes and comorbid NAFLD were either randomized to receive 50 mg/day of ipragliflozin as an add-on treatment (n = 29) or maintained on metformin and pioglitazone (n = 15). The fatty burden was assessed using the fatty liver index, NAFLD liver fat score, and controlled attenuation parameter (CAP). Changes in fat and muscle depots were measured by dual-energy x-ray absorptiometry and abdominal computed tomography scans. The enrolled patients were relatively controlled (mean baseline glycated hemoglobin of 6.6% ± 0.6%) and centrally obese (mean waist circumference of 101.6 ± 10.9 cm). At week 24, patients in the ipragliflozin add-on group exhibited reduced hepatic fat content (fatty liver index: −9.8 ± 1.9, p = 0.002; NAFLD liver fat score: −0.5 ± 0.2, p = 0.049; CAP: −8.2 ± 7.8 dB/m2, p = 0.133). Ipragliflozin add-on therapy also reduced whole-body visceral fat and the ratio of visceral to subcutaneous fat (change in whole-body visceral fat: −69.6 ± 21.5 g; change in abdominal visceral fat: −26.2 ± 3.7 cm2; abdominal visceral to subcutaneous fat ratio: −0.15 ± 0.04; all p < 0.05). In conclusion, ipragliflozin treatment significantly ameliorates liver steatosis and reduces excessive fat in euglycemic patients with type 2 diabetes and NAFLD taking metformin and pioglitazone.

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“…The main goals in NAFLD management are moderate body weight reduction (7%-10%) and increased physical activity [6], while, despite first promising clinical studies with anti-diabetic and anti-inflammatory drugs [4], no specific medical treatment for NAFLD is approved so far [7]. Several studies have analyzed the relationships between dietary factors and NAFLD in recent years [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Dietary Factors in Relation to Liver Fat Content: A Cross-sectional Study

et al. 2020

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Non-alcoholic fatty liver disease (NAFLD) can lead to functional liver impairment and severe comorbidities. Beyond energy balance, several dietary factors may increase NAFLD risk, but human studies are lacking. The aim of this cross-sectional study was to investigate the associations between food consumption (47 food groups, derived Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diet quality scores) and liver fat content (continuous scale and NAFLD, i.e., >5% liver fat content). Liver fat content was measured by magnetic resonance imaging (MRI) in 136 individuals (BMI: 25–40 kg/m2, age: 35–65, 50.7% women) and food intake was recorded by food frequency questionnaires (FFQs). Associations between food items and liver fat were evaluated by multi-variable regression models. Intakes of cake and cookies as well legumes were inversely associated with liver fat content, while positive associations with intakes of high-fat dairy and cheese were observed. Only cake and cookie intake also showed an inverse association with NAFLD. This inverse association was unexpected, but not affected by adjustment for reporting bias. Both diet quality scores were inversely associated with liver fat content and NAFLD. Thus, as smaller previous intervention studies, our results suggest that higher diet quality is related to lower liver fat, but larger trials with iso-caloric interventions are needed to corroborate these findings.

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EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease

Cited by 402 publications

References 149 publications

Effects of an Intensive Inpatient Rehabilitation Program in Elderly Patients with Obesity

Effects of an Intensive Inpatient Rehabilitation Program in Elderly Patients with Obesity

Ipragliflozin Additively Ameliorates Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Controlled with Metformin and Pioglitazone: A 24-Week Randomized Controlled Trial

Dietary Factors in Relation to Liver Fat Content: A Cross-sectional Study

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