title: Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis.
abstract: Nonalcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease in industrialized countries worldwide, and has become a serious public health issue not only in Western countries but also in many Asian countries including Japan. Within the wide spectrum of NAFLD, nonalcoholic steatohepatitis (NASH) is a progressive form of disease, which often develops into liver cirrhosis and increases the risk of hepatocellular carcinoma. In turn, a large proportion of NAFLD/NASH is the liver manifestation of metabolic syndrome, suggesting that NAFLD/NASH plays a key role in the pathogenesis of systemic atherosclerotic diseases. Currently, a definite diagnosis of NASH requires liver biopsy, though various noninvasive measures are under development. The mainstays of prevention and treatment of NAFLD/NASH include dietary restriction and exercise; however, pharmacological approaches are often necessary. Currently, vitamin E and thiazolidinedione derivatives are the most evidence-based therapeutic options, although the clinical evidence for long-term efficacy and safety is limited. This practice guideline for NAFLD/NASH, established by the Japanese Society of Gastroenterology in cooperation with The Japan Society of Hepatology, covers lines of clinical evidence reported internationally in the period starting from 1983 to January 2012, and each clinical question was evaluated using the GRADE system. Based on the primary release of the full version in Japanese, this English summary provides the core essentials of this clinical practice guideline comprising the definition, diagnosis, and current therapeutic recommendations for NAFLD/NASH in Japan.
authors.affiliation: Guidelines Committee for creating and evaluating the "Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13 Ginza, Chuo, Tokyo, 104-0061, Japan, sumio@juntendo.ac.jp.
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
authors.forename: Etsuko
authors.initials: E
authors.lastname: Hashimoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ikejima
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Uto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ono
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Masataka
authors.initials: M
authors.lastname: Seike
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tokushige
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoneda
authors.forename: Toshiji
authors.initials: T
authors.lastname: Saibara
authors.forename: Goshi
authors.initials: G
authors.lastname: Shiota
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakamuta
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.forename: Hirohito
authors.initials: H
authors.lastname: Tsubouchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D050110:Bariatric Surgery; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D008019:Life Style; D016031:Liver Transplantation; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D045162:Thiazolidinediones / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use
chemical_list: D045162:Thiazolidinediones; D014810:Vitamin E