Nonalcoholic steatohepatitis: a review of the literature and updates in management.
Nonalcoholic steatohepatitis is a common cause of liver inflammation and is associated with obesity, insulin resistance, and hyperlipidemia. There are concerns that it may turn out to be the most common cause of liver failure as prevalence of obesity increases. It leads to increased morbidity and mortality. Other causes of liver inflammation, especially alcoholic liver disease, must be ruled out. The diagnosis is suggested by abnormalities in the blood work and metabolic panel in an obese patient. Despite advances made in our understanding regarding the pathogenesis and trials with multiple drugs targeting mechanisms in pathogenesis, there are no consistent guidelines regarding treatment. However, multiple sources advocate weight reduction, optimum blood glucose control, and elimination of medications that cause fatty infiltration. The purpose of our article is to detail advances made in identifying disease mechanisms and treatment modalities, including surgery to promote weight loss.
Pasumarthy
Lakshmi
L
Department of Medicine and Gastroenterology, York Hospital, York, PA 17405, USA. lpasumarthy@wellspan.org
Srour
James
J
D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D005234:Fatty Liver / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology; D007333:Insulin Resistance / Q000502:physiology; D017093:Liver Failure / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008111:Liver Function Tests; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D055553:Prescription Drugs / Q000009:adverse effects; D012307:Risk Factors; D015431:Weight Loss
D001786:Blood Glucose; D055553:Prescription Drugs