Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are multidisciplinary liver diseases that often accompany type 2 diabetes or metabolic syndrome, which are characterized by insulin resistance. Therefore, effective treatment of type 2 diabetes and metabolic syndrome s...

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Main Author: Kei Nakajima
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:International Journal of Hepatology
Online Access:http://dx.doi.org/10.1155/2012/950693
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author Kei Nakajima
author_facet Kei Nakajima
author_sort Kei Nakajima
collection DOAJ
description Nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are multidisciplinary liver diseases that often accompany type 2 diabetes or metabolic syndrome, which are characterized by insulin resistance. Therefore, effective treatment of type 2 diabetes and metabolic syndrome should target not only the cardiometabolic abnormalities, but also the associated liver disorders. In the last decade, it has been shown that metformin, thiazolidinediones, vitamin E, ezetimibe, n-3 polyunsaturated fatty acids, renin-angiotensin system (RAS) blockers, and antiobesity drugs may improve hepatic pathophysiological disorders as well as clinical parameters. Accordingly, insulin sensitizers, antioxidative agents, Niemann-Pick C1-like 1 (NPC1L1) inhibitors, RAS blockers, and drugs that target the central nervous system may represent candidate pharmacotherapies for NAFLD and possibly NASH. However, the efficacy, safety, and tolerability of long-term treatment (potentially for many years) with these drugs have not been fully established. Furthermore, clinical trials have not comprehensively examined the efficacy of lipid-lowering drugs (i.e., statins, fibrates, and NPC1L1 inhibitors) for the treatment of NAFLD. Although clinical evidence for RAS blockers and incretin-based agents (GLP-1 analogs and dipeptidyl peptidase-4 inhibitors) is also lacking, these agents are promising in terms of their insulin-sensitizing and anti-inflammatory effects without causing weight gain.
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spelling doaj-art-06f889e4416e4495a3a05a87273bfcfb2025-08-20T02:02:51ZengWileyInternational Journal of Hepatology2090-34482090-34562012-01-01201210.1155/2012/950693950693Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver DiseaseKei Nakajima0Division of Clinical Nutrition, Department of Medical Dietetics, Faculty of Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Saitama, Sakado 350-0295, JapanNonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are multidisciplinary liver diseases that often accompany type 2 diabetes or metabolic syndrome, which are characterized by insulin resistance. Therefore, effective treatment of type 2 diabetes and metabolic syndrome should target not only the cardiometabolic abnormalities, but also the associated liver disorders. In the last decade, it has been shown that metformin, thiazolidinediones, vitamin E, ezetimibe, n-3 polyunsaturated fatty acids, renin-angiotensin system (RAS) blockers, and antiobesity drugs may improve hepatic pathophysiological disorders as well as clinical parameters. Accordingly, insulin sensitizers, antioxidative agents, Niemann-Pick C1-like 1 (NPC1L1) inhibitors, RAS blockers, and drugs that target the central nervous system may represent candidate pharmacotherapies for NAFLD and possibly NASH. However, the efficacy, safety, and tolerability of long-term treatment (potentially for many years) with these drugs have not been fully established. Furthermore, clinical trials have not comprehensively examined the efficacy of lipid-lowering drugs (i.e., statins, fibrates, and NPC1L1 inhibitors) for the treatment of NAFLD. Although clinical evidence for RAS blockers and incretin-based agents (GLP-1 analogs and dipeptidyl peptidase-4 inhibitors) is also lacking, these agents are promising in terms of their insulin-sensitizing and anti-inflammatory effects without causing weight gain.http://dx.doi.org/10.1155/2012/950693
spellingShingle Kei Nakajima
Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease
International Journal of Hepatology
title Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease
title_full Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease
title_fullStr Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease
title_full_unstemmed Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease
title_short Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease
title_sort multidisciplinary pharmacotherapeutic options for nonalcoholic fatty liver disease
url http://dx.doi.org/10.1155/2012/950693
work_keys_str_mv AT keinakajima multidisciplinarypharmacotherapeuticoptionsfornonalcoholicfattyliverdisease