A Critical Approach of Guideline Therapeutic Recommendations for NAFLD

Title:A Critical Approach of Guideline Therapeutic Recommendations for NAFLD

Volume: 16 Issue: 3

Author(s): Dragan B. Djordjevic, Marija Zdravkovic, Aleksandar Nagorni, Athanasios Manolis, Costas Tsioufis and Dragan Lovic*

Affiliation:

• Clinic for Internal disease Intermedica, Nis,Serbia

Keywords: Non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, cardiovascular disease, insulin resistance, diabetes, obesity, statins.

Abstract: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) as progressive form of the disease are associated with cardiovascular risk factors including obesity, dyslipidaemia, hyperglycaemia and hypertension. When NAFLD is associated with cardiovascular disease, mortality of NAFLD patients is increased due to cardiovascular disease. Prevalence of NAFLD and NASH is high, but it seems that epidemic of the disease is under-recognized and under-appreciated. Linking pathophysiological mechanisms are complex and still not well understood. The main related pathophysiological mechanisms are lipid factors, insulin resistance, inflammation, proinflammatory cytokines, oxidative stress, pro-coagulant status, hyperglycaemia and adipokines. First-line management focuses on lifestyle modifications in both diseases. Several therapeutic interventions, insulin sensitizer agents, lipid lowering drugs, antioxidants, such as vitamin E, have been proposed. Statins appear to be safe, but their use in the treatment of NAFLD and NASH is under-appreciated. Many different agents are being investigated as future drugs for the treatment of this clinical entity. The aim of the review is to examine the extent of the epidemic and the mediating mechanisms, to critically evaluate current guideline recommendations, and to consider current and future medications for this disease.

Cite this article as:

Djordjevic B. Dragan, Zdravkovic Marija , Nagorni Aleksandar, Manolis Athanasios, Tsioufis Costas and Lovic Dragan*, A Critical Approach of Guideline Therapeutic Recommendations for NAFLD, Current Vascular Pharmacology 2018; 16 (3) . https://dx.doi.org/10.2174/1570161115666170621080228