Managing the combination of nonalcoholic fatty liver disease and metabolic syndrome

Abstract

All NAFLD patients should be evaluated for their metabolic, cardiovascular and liver-related risk. Weight loss through lifestyle intervention remains the most comprehensive and safe treatment of NAFLD and associated MetS; however, > 50% of patients fail to achieve target weight loss. Pharmacologic treatment seems to be important for these patients and for NAFLD cases with more advanced liver disease. It temporarily reverses metabolic alterations, but liver disease progresses after the treatment is stopped. Although current treatments are unsatisfactory, new drugs have been proposed and a few innovative compounds are in the pipeline of pharmaceutical companies. Before pharmacologic treatment can be routinely recommended for NAFLD, long-term randomized trials are needed, along with assessments of the safety and benefits of drugs on proper histological outcomes or validated surrogate markers. The intensive control of individual features of MetS remains mandatory.

A standard ballroom and Latin dance program to improve fitness and adherence to physical activity in individuals with type 2 diabetes and in obesity

“…The modest but significant reduction of liver enzymes is likely to reflect decreased hepatic triglyceride accumulation [30], as commonly observed in nonalcoholic fatty liver disease entering specific activity programs, also independent of weight loss [31,32]. It should be viewed in the context of the chronic liver disease associated with obesity and diabetes, where intense behavioral treatment [33], also leading to improved glucose control, reduced insulin levels and improved insulin sensitivity [34], is expected to stop liver disease progression [33,35]. …”

Longitudinal study of circulating miR-122 in a rat model of non-alcoholic fatty liver disease

“…The frequency of NAFLD has increased over the last twenty years, and this condition now affects 20%-30% of the population in western societies [9]. NAFLD is closely associated with obesity, insulin resistance, and hyperlipidemia, and NAFLD increases the risk of cardiovascular disease, type 2 diabetes, and liver-related complications [10,11]. Most persons with NAFLD are asymptomatic, and NAFLD is …”

Myocardial Insulin Resistance: An Overview of Its Causes, Effects, and Potential Therapy

“…Metformin decreases hepatic gluconeogenesis and triglyceride production which in turn enhances insulin sensitivity [258]. Metformin reduced the progression of insulin resistance (prediabetic) to type-2 diabetes in the Diabetes Prevention Program [243].…”

“…Thiazolidinediones (TZDs) are PPAR agonists that regulate insulin sensitivity in the liver, muscle and adipose tissue by increasing fatty acid oxidation and decreasing fatty acid synthesis [258]. TZDs are also believed to have anti-inflammatory effects.…”