[Nonalcoholic steatohepatitis: diagnosis, pathogenesis, treatment and prognosis].
Nonalcoholic steatohepatitis and chronic viral hepatitis C are the two dominant liver diseases in the Netherlands. Hepatic steatosis is usually innocuous but in twenty percent of patients it develops into steatohepatitis. One-fifth of these patients develop liver cirrhosis and hepatocellular carcinoma can also be a consequence of the disease. Nonalcoholic steatohepatitis is characterized by macrovesicular steatosis, necroinflammation, loss ofhepatocytes and fibrosis. Nonalcoholic steatohepatitis often is associated with type 2 diabetes mellitus, hypertension, dyslipoproteinemia and obesity. Insulin resistance plays a major role in the pathogenesis of this disease. Drugs against insulin resistance can ameliorate nonalcoholic steatohepatitis. Gradual weight loss, a diet including polyunsaturated fatty acids and exercise are other important treatment components of this condition.
Jansen
P L M
PL
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Maag-, Darm- en Leverziekten, Levercentrum, Meibergdreefg, 1105 AZ Amsterdam. p.l.jansen@amc.uva.nl
D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D002908:Chronic Disease; D018450:Disease Progression; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006505:Hepatitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000209:etiology*; D008113:Liver Neoplasms / Q000209:etiology*; D009765:Obesity / Q000150:complications / Q000378:metabolism; D011379:Prognosis; D015431:Weight Loss