Research Article Details
| Article ID: | A06300 |
| PMID: | 32936098 |
| Source: | J R Coll Physicians Edinb |
| Title: | Diagnosis and management of fatty liver. |
| Abstract: | Globally, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing rapidly and constitutes a significant healthcare burden due to associated complications including hepatic (cirrhosis and hepatocellular cancer) and non-hepatic (cardiovascular deaths) disorders. It is closely linked to insulin resistance and metabolic syndrome but moderate alcohol consumption frequently coexists. Recently, genetic polymorphisms were implicated in the development of non-obese NAFLD. Apart from liver biopsy, in order to assess for steatosis, fibrosis and non-alcoholic steatohepatitis (NASH), advances in non-invasive serum tests and elastography have provided similarly accurate, more accessible and safer alternatives for risk stratification. As for treatment in 2020, weight loss and lifestyle modification remain the central strategy. Unfortunately, no pharmacological agents have been approved thus far, but there are a number of potential therapies in the pipeline for fibrosis and NASH. Treatment of underlying metabolic disorders is important. While the term NAFLD was coined in the 1980s, more recent understanding may support a change in nomenclature highlighting its strong metabolic roots. |
| DOI: | 10.4997/JRCPE.2020.308 |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs | |
|---|---|---|---|---|---|
| S08 | Lifestyle measures | Lifestyle intervention; weight loss; diet adaptation; dietary interventions; lifestyle modifications; Exercise | -- | -- | Details |
| S01 | Improve insulin resistance | insulin sensitizer; insulin resistance; glucose tolerance | Biguanide: increases 5-AMP activated protein kinase signaling; SGLT-2 inhibitor; Thiazalidinedione: selective PPAR-γ agonists; GLP-1 agonist | Metformin; Empagliflozin; Canagliflozin; Rosiglitazone; Pioglitazone; Liraglutide | 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 |
| 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 |
| Drug ID | Drug Name | Type | DrugBank ID | Targets | Category | Latest Progress | |
|---|---|---|---|---|---|---|---|
| D328 | Serine | Chemical drug | DB00133 | SRR | Improve insulin resistance | Under clinical trials | Details |
| D579 | Emfilermin | Miscellany | -- | adipocytes | Enhance lipid metabolism | Under investigation | Details |
| D083 | CLA | Chemical drug | DB01211 | KCNH2; SLCO1B1; SLCO1B3 | -- | Under clinical trials | Details |
| D182 | Insulin | Biological drug | DB00030 | INSR agonist; CPE modulator&product of | -- | Under clinical trials | Details |