title: Nonalcoholic fatty liver disease: predisposing factors and the role of nutrition.
abstract: More than 20% of Americans have nonalcoholic fatty liver disease (NAFLD), and this is, by far, the leading cause of abnormal liver enzymes in the United States. Nonalcoholic steatohepatitis (NASH), a more serious form of NAFLD, can proceed to cirrhosis and even hepatocellular carcinoma. These liver diseases represent the hepatic component of the metabolic syndrome, and this spectrum of liver disease represents a major health problem both in the United States and worldwide. Hepatic steatosis is closely linked to nutrition, including obesity, possibly high-fructose corn syrup consumption and consumption of certain types of fats. There are a variety of second insults or "hits" that appear to transform simple steatosis into NASH, with some of these second hits including certain proinflammatory cytokines, oxidative stress and possibly industrial toxins. In certain underdeveloped countries, it appears likely that industrial toxins play a role in NASH, and there is increasing interest in the potential interaction of industrial toxins and nutrients. Moreover, optimal therapy for NAFLD appears to include lifestyle modification with exercise, diet and weight loss. Certain nutrients may also be of benefit. Important areas for future research are the effect(s) of nutritional supplements on NAFLD/NASH and the effects of industrial toxins.
authors.affiliation: Department of Medicine, University of Louisville Medical Center, Louisville, KY 40292, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Cave
authors.forename: Ion
authors.initials: I
authors.lastname: Deaciuc
authors.forename: Christian
authors.initials: C
authors.lastname: Mendez
authors.forename: Zhenyuan
authors.initials: Z
authors.lastname: Song
authors.forename: Swati
authors.initials: S
authors.lastname: Joshi-Barve
authors.forename: Shirish
authors.initials: S
authors.lastname: Barve
authors.forename: Craig
authors.initials: C
authors.lastname: McClain
mesh_terms: D001622:Betaine / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D019587:Dietary Supplements; D004781:Environmental Exposure; D005234:Fatty Liver / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D008099:Liver / Q000201:enzymology / Q000502:physiology; D008103:Liver Cirrhosis / Q000209:etiology; D024821:Metabolic Syndrome / Q000453:epidemiology; D008715:Methionine / Q000378:metabolism; D008875:Middle Aged; D028361:Mitochondrial Diseases / Q000503:physiopathology; D018384:Oxidative Stress; D012436:S-Adenosylmethionine / Q000378:metabolism; D014481:United States / Q000453:epidemiology; D014810:Vitamin E / Q000008:administration & dosage; D015262:Xenobiotics / Q000378:metabolism / Q000494:pharmacology; D015032:Zinc / Q000008:administration & dosage
chemical_list: D016207:Cytokines; D015262:Xenobiotics; D014810:Vitamin E; D001622:Betaine; D012436:S-Adenosylmethionine; D008715:Methionine; D015032:Zinc