Research Article Details
| Article ID: | A10426 |
| PMID: | 31341444 |
| Source: | Integr Med (Encinitas) |
| Title: | Non-Alcoholic Fatty Liver Disease, an Overview. |
| Abstract: | Nonalcoholic fatty liver disease (NAFLD) affects 25% of people worldwide. Patients with fatty liver disease are primarily asymptomatic. Currently, specialists are predicting that fatty liver related cirrhosis will the be leading reason for liver transplants in the next 10-20 years, displacing hepatitis C and alcohol related liver transplants. NAFLD exists on a spectrum of simple steatosis to steatosis with inflammation and different levels of fibrosis. It is currently estimated that 20% of simple steatosis patients will progress to nonalcoholic steatohepatitis (NASH). Patients with NASH are at risk for further progression to cirrhosis and hepatocellular carcinoma. There is no single factor that triggers progression from simple steatosis to NASH, however, we do know that NASH is more prevalent in patients with obesity, diabetes, and metabolic syndrome. NAFLD is thought to be the hepatic manifestation of metabolic syndrome, and is closely tied with hyperinsulinemia. Currently there are no approved FDA treatments for NAFLD. NAFLD is typically found incidentally on imaging such as abdominal ultrasound and CT. Elevations in alanine aminotransferase (ALT) may prompt the clinician to evaluate for NAFLD however ALT should not be used as a diagnostic tool. The gold standard for diagnosis of NAFLD and NASH is a liver biopsy. Only a liver biopsy can distinguish simple steatosis from NASH. In patients whom NAFLD is suspected, appropriate biochemical assessment and imaging should be evaluated. Also, the presence of fibrosis should be assessed. Weight loss and dietary modifications are currently the only recommendations provided to NAFLD patients. There is histological improvement seen in in patients whom lose 5-10% of their body weight. Certain dietary factors play a role in the development of NAFLD including excessive caloric intake and high fructose consumption. There are pharmacological treatments currently being studied as well as non-pharmacological agents. This overview focuses on evaluation, management and treatments in NAFLD. |
| DOI: |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs | |
|---|---|---|---|---|---|
| S08 | Lifestyle measures | Lifestyle intervention; weight loss; diet adaptation; dietary interventions; lifestyle modifications; Exercise | -- | -- | Details |
| S03 | Anti-fibrosis | fibrosis | Angiotensin Receptor Blocker (ARB); CCR2/CCR5 antagonist; Thyroid receptor β agonist; PEGylated human FGF21 analogue; Monoclonal antibody to lysyl oxidase-like 2 (LOXL2); Galectin-3 inhibitor; FGF19 variant | Losartan; Cenicriviroc; VK-2809; MGL-3196; Pegbelfermin; Simtuzumab; GR-MD-02; NGM282 | Details |
| Target ID | Target Name | GENE | Action | Class | UniProtKB ID | Entry Name |
|---|
| Diseases ID | DO ID | Disease Name | Definition | Class | |
|---|---|---|---|---|---|
| I05 | 9352 | Type 2 diabetes mellitus | A diabetes that is characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. A diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. http://en.wikipedia.org/wiki/Diabetes, http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2 | disease of metabolism/inherited metabolic disorder/ carbohydrate metabolic disorder/glucose metabolism disease/diabetes/ diabetes mellitus | Details |
| I14 | 9970 | Obesity | An overnutrition that is characterized by excess body fat, traditionally defined as an elevated ratio of weight to height (specifically 30 kilograms per meter squared), has_material_basis_in a multifactorial etiology related to excess nutrition intake, decreased caloric utilization, and genetic susceptibility, and possibly medications and certain disorders of metabolism, endocrine function, and mental illness. https://en.wikipedia.org/wiki/Obesity | disease of metabolism/acquired metabolic disease/ nutrition disease/overnutrition | Details |
| Drug ID | Drug Name | Type | DrugBank ID | Targets | Category | Latest Progress | |
|---|---|---|---|---|---|---|---|
| D182 | Insulin | Biological drug | DB00030 | INSR agonist; CPE modulator&product of | -- | Under clinical trials | Details |
| D142 | Fructose | Chemical drug | DB04173 | -- | Intravenous nutrition drug | Under clinical trials | Details |
| D199 | L-alanine | Chemical drug | DB00160 | KYNU | -- | Failed in clinical trials | Details |