Diet and exercise in NAFLD/NASH: Beyond the obvious

Liver International, Journal Year: 2021, Volume and Issue: 41(10), P. 2249 - 2268

Published: July 30, 2021

Lifestyle represents the most relevant factor for non-alcoholic fatty liver disease (NAFLD) as hepatic manifestation of metabolic syndrome. Although a tremendous body clinical and preclinical data on effectiveness dietary lifestyle interventions exist, complexity this topic makes firm evidence-based recommendations nutrition exercise in NAFLD difficult. The aim review is to guide readers through labyrinth recent scientific findings diet steatohepatitis (NASH), summarizing "obvious" holistic manner simultaneously highlighting stimulating aspects translational research "beyond obvious". Specifically, importance calorie restriction regardless composition evidence from low-carbohydrate diets target incidence severity are discussed. aspect ketogenesis-potentially achieved via intermittent restriction-seems be central these warranting further investigation. Interactions with gut microbiota individual genetic background need comprehensively understood order develop personalized concepts strategies patients NAFLD/NASH.

Language: Английский

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Pathogenesis and treatment of non-alcoholic steatohepatitis and its fibrosis

Clinical and Molecular Hepatology, Journal Year: 2022, Volume and Issue: 29(1), P. 77 - 98

Published: Oct. 13, 2022

The initial presentation of non-alcoholic steatohepatitis (NASH) is hepatic steatosis. dysfunction lipid metabolism within hepatocytes caused by genetic factors, diet, and insulin resistance causes accumulation. Lipotoxicity, oxidative stress, mitochondrial dysfunction, endoplasmic reticulum stress would further contribute to hepatocyte injury death, leading inflammation immune in the liver. During healing process, accumulation an excessive amount fibrosis might occur while healing. development NASH liver fibrosis, gut-liver axis, adipose-liver renin-angiotensin system (RAS) may be dysregulated impaired. Translocation bacteria or its end-products entering could activate hepatocytes, Kupffer cells, stellate exacerbating steatosis, inflammation, fibrosis. Bile acids regulate glucose through Farnesoid X receptors intestine. Increased adipose tissue-derived non-esterified fatty aggravate leptin also plays a role fibrogenesis, decreased adiponectin resistance. Moreover, dysregulation peroxisome proliferator-activated liver, adipose, muscle tissues impair metabolism. In addition, RAS acid metabolism, treatment includes lifestyle modification, pharmacological therapy, non-pharmacological therapy. Currently, weight reduction modification surgery most effective However, vitamin E, pioglitazone, obeticholic have been suggested. this review, we will introduce some new clinical trials experimental therapies for related

Language: Английский

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Defining comprehensive models of care for NAFLD

Nature Reviews Gastroenterology & Hepatology, Journal Year: 2021, Volume and Issue: 18(10), P. 717 - 729

Published: June 25, 2021

Language: Английский

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Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention

Cardiovascular Diabetology, Journal Year: 2022, Volume and Issue: 21(1)

Published: Dec. 3, 2022

The newly proposed term "metabolic dysfunction-associated fatty liver disease" (MAFLD) is replacing the old "non-alcoholic (NAFLD) in many global regions, because it better reflects pathophysiology and cardiometabolic implications of this common disease. change terminology from NAFLD to MAFLD not simply a single-letter an acronym, since defined by set specific positive diagnostic criteria. In particular, definition specifically incorporates within classification recognized cardiovascular risk factors. Although convincing evidence supports significant association between both MAFLD, with increased CVD morbidity mortality, neither nor have received sufficient attention Cardiology community. fact, there paucity scientific guidelines focusing on burdensome disease professional societies. This Perspective article discusses rationale clinical relevance for Cardiologists definition.

Language: Английский

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An international multidisciplinary consensus statement on MAFLD and the risk of CVD

Hepatology International, Journal Year: 2023, Volume and Issue: 17(4), P. 773 - 791

Published: May 19, 2023

Language: Английский

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