Non-alcoholic fatty liver disease: when to intervene and with what

Abstract

Non-alcoholic fatty liver disease: when to intervene and with whatNon-alcoholic fatty liver disease (NAFLD) is increasingly common due to the rising prevalence of obesity in both children and adults. It is associated with metabolic risk factors such as diabetes mellitus, dyslipidaemia and hypertension, and is associated with increased mortality both from cardiovascular-related and liver-related deaths. Identifi cation of those individuals with signifi cant infl ammation and fi brosis is a critical part of the patient pathway. Current treatments for NAFLD include weight loss from lifestyle modifi cation or bariatric surgery, management of underlying metabolic risk factors and for those with end stage liver disease, liver transplantation.

Role of bariatric surgery in treatment of non-alcoholic fatty liver disease

“…50 New studies show that bariatric surgery can improve the histologic features of steatosis, hepatocyte ballooning and lobular inflammation, but it effect in liver fibrosis is on debate. 51 Role of bariatric surgery in treatment of non-alcoholic fatty liver disease…”

Mitigating the scourge of non-alcoholic fatty liver disease in Ghana

“…19 There are currently no approved pharmacological interventions for NAFLD, and current management strategies aim to identify and treat features of the metabolic syndrome, in order to reduce long-term cardiovascular and liver-related morbidity and mortality. 20 Features of the metabolic syndrome should be aggressively managed, with a focus on weight loss. This is difficult to achieve in this population; even in highly supervised randomized clinical trials (RCTs), less than 50% participants have been shown to achieve the ideal 7% total body weight reduction.…”

The Role of a Dedicated Non-Alcoholic Fatty Liver Disease Clinic in 2016

“…There are no approved pharmacological interventions for NAFLD, and current management strategies aim to identify and treat features of the metabolic syndrome, in order to reduce long-term cardiovascular and liver-related morbidity and mortality [6] . Indeed, it has long been established that cardiovascular disease is the commonest cause of death in NAFLD [7] .…”