ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 10
Oct.  2018
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Article Contents

Research advances in the treatment of nonalcoholic fatty liver disease

DOI: 10.3969/j.issn.1001-5256.2018.10.038
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  • Received Date: 2018-06-27
  • Published Date: 2018-10-20
  • Nonalcoholic fatty liver disease ( NAFLD) has become the leading cause of abnormal liver enzymes in healthy individuals in China. Due to the complex pathogenesis of NAFLD, no consensus has been reached on the treatment of this disease. However, in recent years, more and more studies have put forward more pathogeneses and corresponding treatment recommendations. This article introduces and summarizes the research advances in the treatment of NAFLD, including lifestyle intervention, drug treatment, eradication of Helicobacter pylori, surgical treatment, regulation of intestinal microecology, and gene therapy.


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  • [1]YOUNOSSI ZM, KOENIG AB, ABDELATIF D, et al.Global epidemiology of non-alcoholic fatty liver disease-Meta-analytic assessment of prevalence, inci-dence, and outcomes[J].Hepatology, 2016, 64 (1) :73-84.
    [2]ZHU JZ, ZHOU QY, WANG YM, et al.Prevalence of fatty liver disease and the economy in China:A systematic review[J].World J Gastroenterol, 2015, 21 (18) :5695-5706.
    [3]CHITTURI S, WONG VW, CHAN WK, et al.The Asia-Pacific Working Party on Nonalcoholic Fatty Liver Disease Guidelines 2017Part 2:Management and special groups[J].J Gastroenterol Hepatol, 2018, 33 (1) :86-98.
    [4]European Association for the Study of the Liver (EASL) , European Association for the Study of Diabetes (EASD) , European Association for the Study of Obesity (EASO) .EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease[J].J Hepatol, 2016, 64 (6) :1388-1402.
    [5]LU W, LI S, LI J, et al.Effects of omega-3 fatty acid in nonalcoholic fatty liver disease:A meta-analysis[J].Gastroenterol Res Pract, 2016, 2016:1459790.
    [6]VIAR-GOMEZ E, MARTINEZ-PEREZ Y, CALZADILLA-BERTOT L, et al.Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis[J].Gastroenterology, 2015, 149 (2) :367-378.e5;quiz e14-15.
    [7]ZHANG HJ, HE J, PAN LL, et al.Effects of moderate and vigorous exercise on nonalcoholic fatty liver disease:A randomized clinical trial[J].JAMA Intern Med, 2016, 176 (8) :1074-1082.
    [8]RATZIU V, GOODMAN Z, SANYAL A.Current efforts and trends in the treatment of NASH[J].J Hepatol, 2015, 62 (1) :s65-s75.
    [9]TAO YT, FAN JG.Psychological stress in nonalcoholic fatty liver diseases[J].J Prac Hepatol, 2016, 19 (6) :753-756. (in Chinese) 陶叶婷, 范建高.心理应激与非酒精性脂肪性肝病[J].实用肝脏病杂志, 2016, 19 (6) :753-756.
    [10]LIU YZ, CHEN JK, ZHANG Y, et al.Chronic stress induces steatohepatitis while decreases visceral fat mass in mice[J].BMCGastroenterol, 2014, 14:106.
    [11]WANG T, LI M, CHEN B, et al.Urinary bisphenol A (BPA) concentration associates with obesity and insulin resistance[J].J Clin Endocrinol Metab, 2012, 97 (2) :e223-227.
    [12]CHANG BX.EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease (2016) [J].JClin Hepatol, 2016, 32 (8) :1450-1454. (in Chinese) 常彬霞.2016年欧洲肝病学会、欧洲糖尿病学会和欧洲肥胖学会临床实践指南:非酒精性脂肪性肝病[J].临床肝胆病杂志, 2016, 32 (8) :1450-1454.
    [13]SANYAL AJ, CHALASANI N, KOWDLEY KV, et al.Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis[J].NEngl J Med, 2010, 362 (18) :1675-1685.
    [14]RATZIU V, GIRAL P, JACQUEMINET S, et al.Rosiglitazone for non-alcoholic steatohepatitis:One-year results of the randomized placebo-controlled Fatty Liver Improvement with Rosiglitazone Therapy (FLIRT) Trial[J].Gastroenterol, 2008, 135 (135) :100-110.
    [15]BOETTCHER E, CSAKO G, PUVINO F, et al.Meta analysis:Pioglitazone improves liver histology and fibrosis in patients with non alcoholic steatohepatitis[J].Aliment Pharmacol Ther, 2012, 35 (1) :66-75.
    [16]CUSI K, ORSAK B, BRIL F, et al.Long-term pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus:A randomized trial[J].Ann Intern Med, 2016, 165:305-315.
    [17]LEE M, SAVER JL, LIAO HW, et al.Pioglitazone for secondary stroke prevention:A systematic review and meta-analysis[J].Stroke, 2017, 48:388-393.
    [18]TANG W, XU Q, HONG T.et al.Comparative efficacy of antidiabetic agents on nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus:A systematic review and meta-analysis of randomized and non-randomized studies[J].Diabetes Metab Res Rev, 2016, 32 (2) :200-216.
    [19]ZHANG WH, HE H, WANG Q, et al.Effects of pioglitazone combined with metformin on glucose and lipid metabolism and islet function in obese patients with hyperinsulinemia[J].Chin J Med Offic, 2018, 46 (6) :690-692. (in Chinese) 张卫欢, 何桦, 王倩, 等.吡格列酮联合二甲双胍对肥胖合并高胰岛素血症患者糖脂代谢及胰岛功能影响[J].临床军医杂志, 2018, 46 (6) :690-692.
    [20]TOWNSEND SA, NEWSOME PN.Review article:New treatments in non-alcoholic fatty liver disease[J].Aliment Pharmacol Ther, 2017, 46 (5) :494-507.
    [21]ARMSTRONG MJ, GAUNT P, AITHAL GP, et al.Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN) :A multicentre, double-blind, randomised, placebocontrolled phase 2 study[J].Lancet, 2016, 387 (10019) :679-690.
    [22]ARAB JP, KARPEN SJ, DAWSON PA, et al.Bile acids and nonalcoholic fatty liver disease:Molecular insights and therapeutic perspectives[J].Hepatology, 2017, 65:350-362.
    [23]LEFEBVRE E, GOTTWALD M, LASSETER K, et al.Pharmacokinetics, safety, and CCR2/CCR5 antagonist activity of cenicriviroc in participants with mild or moderate hepatic impairment[J].Clin Transl Sci, 2016, 9:139-148.
    [24]SCERIF M, FMZESI T, THOMAS JD, et al.CB1 receptor mediates the effects of glucocorticoids on AMPK activity in the hypothalamus[J].J Endocrinol, 2013, 219 (1) :79-88.
    [25]CHANDA D, KIM YH, KIM DK, et al.Activation of cannabinoid receptor type 1 (Cb1r) disrupts hepatic insulin receptor signaling via cyclic AMP-response element-binding protein H (Crebh) -mediated induction of Lipin1 gene[J].J Biol Chem, 2012, 287 (45) :38041-38049.
    [26]GITTO S, VITALE G, VILLA E, et al.Treatment of nonalcoholic steatohepatitis in adults:Present and future[J].Gastroenterol Res Pract, 2015, 2015 (8) :1679-1684.
    [27]TANGEN CM, GOODMAN PJ, TILL C, et al.Biases in recommendations for and acceptance of prostate biopsy significantly affect assessment of prostate cancer risk factors:Results from two large randomized clinical trials[J].J Clin Oncol, 2016, 34:4338-4344.
    [28]DONGIOVANNI P, PETTA S, MANNISTO V, et al.Statin use and non-alcoholic steatohepatitis in at risk individuals[J].J Hepatol, 2015, 63 (3) :705-712.
    [29]BRIL F, PORTILLO SANCHEZ P, LOMONACO R, et al.Liver safety of statins in prediabetes or T2DM and nonalcoholic steatohepatitis:Post hoc analysis of a randomized trial[J].J Clin Endocrinol Metab, 2017, 102 (8) :2950-2961.
    [30]SAFADI R, KONIKOFF FM, MAHAMID M, et al.The fatty acid-bile acid conjugate aramchol reduces liver fat content in patients with nonalcoholic fatty liver disease[J].Clin Gastroenterol Hepatol, 2014, 12 (12) :2085-2091.
    [31]WANG H, WANG L, CHENG YJ, et al.Efficacy of orlistat in non-alcoholic fatty liver disease:A systematic review and meta-analysis[J].Biomed Rep, 2018, 9 (1) :90-96.
    [32] National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association;Fatty Liver Expert Committee, Chinese Medical Doctor Association.Guidelines of prevention and treatment for nonalcoholic fatty liver disease:A 2018 update[J].J Clin Hepatol, 2018, 34 (5) :947-957. (in Chinese) 中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会.非酒精性脂肪性肝病防治指南 (2018年更新版) [J].临床肝胆病杂志, 2018, 34 (5) :947-957.
    [33]HE ZT, HAN XY, CHEN YY, et al.Eradication of Helicobacter pylori in the treatment of nonalcoholic fatty liver disease with Helicobacter pylori infection[J].Chin Hepatol, 2017, 22 (3) :244-247. (in Chinese) 何周桃, 韩向阳, 陈益耀, 等.根除幽门螺杆菌在伴幽门螺杆菌感染的非酒精性脂肪性肝病治疗中的应用[J].肝脏, 2017, 22 (3) :244-247.
    [34]MATHURIN P, HOLLEBECQUE A, ARNALSTEEN L, et al.Prospective study of the long-term effects of bariatric surgery on liver injury in patients without advanced disease[J].Gastroenterology, 2009, 137 (2) :532-540.
    [35]KLEBANOFF MJ, COREY KE, CHHATWAL J, et al.Bariatric surgery for nonalcoholic steatohepatitis:A clinical and cost-effectiveness analysis[J].Hepatology, 2017, 65 (4) :1156-1164.
    [36]PAIS R, BARRITT AS, CALMUS Y, et al.NAFLD and liver transplantation:Current burden and expected challenges[J].JHepatol, 2016, 65 (6) :1245-1257.
    [37]LI HB, FU HY, LU TY, et al.Important progress in liver transplantation in 2017[J].Chin J Organ Transplat, 2018, 9 (1) :41-50, 82. (in Chinese) 李海波, 符洪源, 陆桐宇, 等.肝移植领域2017年度重要进展盘点[J].器官移植, 2018, 9 (1) :41-50, 82.
    [38]GABELE E, DOSTERT K, HOFMANN C, et al.DSS induced colitis increases portal LPS levels and enhances hepatic inflammation and fibrogenesis in experimental NASH[J].J Hepatol, 2011, 55 (6) :1391-1399.
    [39]SUEZ J, ELINAV E.The path towards microbiome-based metabolite treatment[J].Nat Microbiol, 2017, 2:17075.
    [40]LU D, GONG DF, LIAO HC, et al.Efficacy of Bifidobacterium quadruple viable bacteria in the treatment of nonalcoholic fatty liver disease[J].Guangdong Med J, 2016, 37 (8) :1221-1222. (in Chinese) 卢丹, 龚大范, 廖惠充, 等.双歧杆菌四联活菌治疗非酒精性脂肪肝的疗效观察[J].广东医学, 2016, 37 (8) :1221-1222.
    [41]SEPIDEH A, KARIM P, HOSSEIN A, et al.Effects of multistrain probiotic supplementation on glycemic and inflammatory indices in patients with nonalcoholic fatty liver disease:A double-blind randomized clinical trial[J].J Am Coll Nutr, 2016, 35 (6) :500-505.
    [42]ZHOU D, PAN Q, SHEN F, et al.Total fecal microbiota transplantation alleviates high-fat diet-induced steatohepatitis in mice via beneficial regulation of gut microbiota[J].Sci Rep, 2017, 7 (1) :1529.
    [43]WANG S, XU M, WANG W, et al.Systematic review:Adverse events of fecal microbiota transplantation[J].PLo S One, 2016, 11 (8) :e161174.
    [44]GONZALEZ-RODRIGUEZ A, VALVERDE AM.RNA interference as a therapeutic strategy for the treatment of liver diseases[J].Curr Pharm Des, 2015, 21 (31) :4574-4586.
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