Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease

Bhat, Ganesh; Baba, Chalamalasetty Sreenivasa; Pandey, Amaresh Chandra; Kumari, Neeraj; Choudhuri, Gourdas

doi:10.4254/wjh.v4.i7.209

Cited by 56 publications

(45 citation statements)

References 35 publications

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“…47,48 An Indian study involving 60 NAFLD patients showed regular aerobic exercise for 30 min/day for at least 5 days a week improved insulin resistance resulting in improvement in ALT (decline from 84.8U/L to 41.3 U/L) and liver histology in NAFLD patients. 44 Similar results were obtained from NASH patients (decline in ALT level from 70.5 U/L to 41.5 U/L) also when they were subjected to aerobic exercise of 30 min/day for at least 5 days a week. and pervasive symptoms in people with NASH which contribute to lack of confidence in NASH patients during exercise.…”

Section: Exercisesupporting

confidence: 72%

Evidence based literature review of clinical management of non-alcoholic fatty liver disease in real world settings

Choudhuri

Gupta

2017

Int J Basic Clin Pharmacol

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The aim of the present review is to understand the gap between real world clinical practices, guidelines recommendations and to propose minimum essentials that can be followed in clinical practice in NAFLD patients in India. A detailed literature search of published medical reports in English language was performed on electronic databases such as PubMed and Cochrane, from 2000 to 2016 using relevant search terms. The search yielded 25 relevant articles whose full texts were retrieved and evaluated. Non-alcoholic fatty liver disease (NAFLD) is an emerging cause of liver disease in India. It is observed that physicians under appreciate the overlap between NAFLD and metabolic risk factors, thus missing a significant proportion of high-risk NAFLD patients. Lifestyle intervention is generally considered the first line therapy for patients with NAFLD without steatohepatitis while pharmacotherapy (in addition to lifestyle intervention) is suggested for patients with non-alcoholic steatohepatitis (NASH). Current therapies are directed towards improving the metabolic parameters which contribute to disease pathogenesis. Pharmacological therapies for NAFLD and NASH include antioxidants such as vitamin E and ursodeoxycholic acid; insulin sensitizers such as metformin and thiazolidinones, weight loss drugs like orlistat and consideration of bariatric surgery for morbidly obese patients. High degree of suspicion is necessary for diagnosing NAFLD in patients with metabolic risk factors. Further studies are required from India as genotype/clinico-pathological profile of Indian NAFLD patients differ from the western population. Further, prospective studies will fill the various missing links associated with management of NAFLD in Indian patients in a more effective manner.

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Section: Exercisesupporting

confidence: 72%

Evidence based literature review of clinical management of non-alcoholic fatty liver disease in real world settings

Choudhuri

Gupta

2017

Int J Basic Clin Pharmacol

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“…Numerous series of patients showed the association of IR with liver fibrosis on NAFLD (17,(22)(23)(24). In our patient cohort, HOMA-IR was significantly higher in cases with advanced fibrosis (F3-4) versus no fibrosis (6.7 ± 3.8 units fibrosis.…”

Section: Discussionmentioning

confidence: 67%

Analytical, anthropometric and dietary factors associated with the development of fibrosis in patients with nonalcoholic fatty liver disease

et al. 2018

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“…Indeed, muscle complex I activity gradually increased with progressing steatosis and fibrosis in that study. Another study found that lifestyle intervention resulting in greater muscle glucose disposal also improved steatosis and NAFLD (5). Although muscle mitochondrial function was not measured in that study, muscle mitochondrial adaptation could be one mechanism to modulate hepatic fat loading during the development of type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…This would increase VLDL export and in turn raise circulating triglycerides (TGs) and LDL cholesterol (3). Some exercise studies support this concept in that reversal of muscle insulin resistance decreases HCL and dyslipidemia in humans at risk for type 2 diabetes (4,5).…”

mentioning

confidence: 96%

Lower Fasting Muscle Mitochondrial Activity Relates to Hepatic Steatosis in Humans

et al. 2014

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OBJECTIVEMuscle insulin resistance has been implicated in the development of steatosis and dyslipidemia by changing the partitioning of postprandial substrate fluxes. Also, insulin resistance may be due to reduced mitochondrial function. We examined the association between mitochondrial activity, insulin sensitivity, and steatosis in a larger human population. RESEARCH DESIGN AND METHODSWe analyzed muscle mitochondrial activity from ATP synthase flux (fATP) and ectopic lipids by multinuclei magnetic resonance spectroscopy from 113 volunteers with and without diabetes. Insulin sensitivity was assessed from M values using euglycemic-hyperinsulinemic clamps and/or from oral glucose insulin sensitivity (OGIS) using oral glucose tolerance tests. RESULTSMuscle fATP correlated negatively with hepatic lipid content and HbA 1c . After model adjustment for study effects and other confounders, fATP showed a strong negative correlation with hepatic lipid content and a positive correlation with insulin sensitivity and fasting C-peptide. The negative correlation of muscle fATP with age, HbA 1c , and plasma free fatty acids was weakened after adjustment. Body mass, muscle lipid contents, plasma lipoproteins, and triglycerides did not associate with fATP. CONCLUSIONSThe association of impaired muscle mitochondrial activity with hepatic steatosis supports the concept of a close link between altered muscle and liver energy metabolism as early abnormalities promoting insulin resistance.

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Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease

Abstract: Life style modification improves insulin resistance resulting in improvement in ALT and liver histology in NAFLD patients.

Cited by 56 publications

References 35 publications

Evidence based literature review of clinical management of non-alcoholic fatty liver disease in real world settings

Evidence based literature review of clinical management of non-alcoholic fatty liver disease in real world settings

Analytical, anthropometric and dietary factors associated with the development of fibrosis in patients with nonalcoholic fatty liver disease

Lower Fasting Muscle Mitochondrial Activity Relates to Hepatic Steatosis in Humans

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