Management of NAFLD

Nonalcoholic fatty liver disease and steatohepatitis are the most common chronic diseases of the liver. The process of their development has not yet been fully elucidated. It is characterized by insulin resistance, hepatic lipid accumulation with a secondary pathologic production of free radicals that induce inflammatory processes and fibrosis. There is no evidence-based therapy. It is important to eliminate the pathogenic factors (excess body weight, disordered carbohydrate metabolism, and hyperlipidemia). Potential modalities of a causal therapy include cannabinoid receptor 1 antagonists which do not cross the blood-brain barrier, cannabinoid receptor 2 agonists; selective serotonin 2C receptor agonist, thiazolidinediones, incretins, and dipeptidyl peptidase inhibitors. Additional therapeutic possibilities of the future may target antioxidant defense, immune-mediated mechanisms, apoptosis, and lipogenesis.

Keywords: Diabetes mellitus, Dipeptidyl peptidase inhibitors, Hyperlipidemia, Incretins, Insulin resistance, Lifestyle modification, Nonalcoholic steatohepatitis, Nonalcoholic steatosis, Thiazolidinediones, Treatment, Vitamin E, Weight loss.