Current best treatment for non-alcoholic fatty liver disease.
Treatment of patients with non-alcoholic fatty liver disease (NAFLD) has typically been focused on the management of associated conditions such as obesity, diabetes mellitus and hyperlipidaemia. NAFLD associated with obesity may be resolved by weight reduction, although the benefits of weight loss have been inconsistent. Improving insulin sensitivity with lifestyle modifications or medications usually improves glucose and lipid levels in patients with diabetes and hyperlipidaemia. Improving insulin sensitivity is expected to improve the liver disease but in many diabetic/hyperlipidaemic patients with NAFLD, the appropriate control of glucose and lipid levels is not always accompanied by improvement of the liver condition. Results of pilot studies evaluating ursodeoxycholic acid, gemfibrozil, betaine, N-acetylcysteine, alphatocopherol, metformin and thiazolidinedione derivatives suggest that these medications may be of potential benefit. This article reviews the treatment modalities currently available for patients with NAFLD, including emerging data from clinical trials evaluating promising medications as well as possibilities for the future.
Angulo
Paul
P
Division of Gastroenterology and Hepatology, Mayo Medical School, Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA. angulohernandez.paul@mayo.edu
D000975:Antioxidants / Q000627:therapeutic use; D002839:Chromans / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000628:therapy; D005234:Fatty Liver / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D015248:Gemfibrozil / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D016031:Liver Transplantation; D009765:Obesity / Q000150:complications* / Q000628:therapy; D013844:Thiazoles / Q000627:therapeutic use; D045162:Thiazolidinediones; D000077288:Troglitazone; D015431:Weight Loss
D000975:Antioxidants; D002839:Chromans; D000960:Hypolipidemic Agents; D013844:Thiazoles; D045162:Thiazolidinediones; D000077288:Troglitazone; D015248:Gemfibrozil