title: Non-alcoholic fatty liver diseases: update on the challenge of diagnosis and treatment.
abstract: The prevalence of non-alcoholic fatty liver disease (NAFLD) is estimated to be 25-30% of the population, and is the most common cause of elevated liver enzymes in Korea. NAFLD is a "hot potato" for pharmaceutical companies. Many clinical trials are underway to develop a first-in-class drug to treat NAFLD. However, there are several challenging issues regarding the diagnosis of NAFLD. Currently, liver biopsy is the gold standard method for the diagnosis of NAFLD and steatohepatitis. Ideally, globally recognized standards for histological diagnosis and methods to optimize observer agreement on biopsy interpretation should be developed. Liver biopsy is the best method rather than a perfect one. Recently, multi-parametric magnetic resonance imagery can estimate the amount of intrahepatic fat successfully and is widely used in clinical trials. But no diagnostic method can discriminate between steatohepatitis and simple steatosis. The other unresolved issue in regard to NAFLD is the absence of satisfactory treatment options. Vitamin E and obeticholic acid have shown protective effects in randomized controlled trials, but this drug has not been approved for use in Korea. This study will provide a description of diagnostic methods and treatments that are currently recommended for NAFLD.
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.|Medical corp, 7th division, Republic of Korea army, Korea.
authors.forename: Hyunwoo
authors.initials: H
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Jun
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Waqar K
authors.initials: WK
authors.lastname: Saeed
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.
authors.forename: Mindie H
authors.initials: MH
authors.lastname: Nguyen
mesh_terms: D015415:Biomarkers / Q000032:analysis; D002635:Chenodeoxycholic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D005234:Fatty Liver / Q000175:diagnosis; D005355:Fibrosis; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014810:Vitamin E / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; C464660:obeticholic acid; D002635:Chenodeoxycholic Acid; D014810:Vitamin E
keywords: Diagnosis; Non-alcoholic fatty liver; Treatment