Universität zu Köln

Demir, Muenevver, Lang, Sonja and Steffen, Hans-Michael (2015). Nonalcoholic fatty liver disease - current status and future directions. J. Dig. Dis., 16 (10). S. 541 - 558. HOBOKEN: WILEY. ISSN 1751-2980

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Abstract

Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease worldwide with a reported prevalence ranging 6-33%, depending on the studied populations. It encompasses a spectrum of liver manifestations ranging from simple steatosis (also known as nonalcoholic fatty liver, NAFL) to nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis, which may ultimately progress to hepatocellular carcinoma. NAFLD is strongly associated with the components of metabolic syndrome, mainly obesity and type 2 diabetes mellitus. NAFLD patients are at increased risk of liver-related as well as cardiovascular mortality. Current paradigm suggests a benign course for NAFL whereas NASH is considered to be the progressive phenotype. Although previously under-recognized accumulating evidence suggests that NAFL may also progress, suggesting a higher number of patients at risk than previously appreciated. Liver biopsy remains the gold standard for definitive diagnosis, but the majority of patients can be diagnosed accurately by noninvasive methods. Approved therapies for NAFLD are still lacking and lifestyle modifications aiming at weight loss remain the mainstay of NAFLD treatment. Intensive research could identify insulin resistance, lipotoxicity and dysbiosis of the gut microbiota as major pathophysiological mechanisms, leading to the development of promising targeted therapies which are currently investigated in clinical trials. In this review we summarized the current knowledge of NAFLD epidemiology, natural history, diagnosis, pathogenesis and treatment and considered future directions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Demir, Muenevver UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffen, Hans-Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-392094
DOI:	10.1111/1751-2980.12291
Journal or Publication Title:	J. Dig. Dis.
Volume:	16
Number:	10
Page Range:	S. 541 - 558
Date:	2015
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1751-2980
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TERM-FOLLOW-UP; TRANSIENT ELASTOGRAPHY; NATURAL-HISTORY; HEPATIC STEATOSIS; NONINVASIVE ASSESSMENT; RISK-FACTORS; VITAMIN-E; HEPATOCELLULAR-CARCINOMA; CARDIOVASCULAR-DISEASE; INSULIN-RESISTANCE Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39209