Advances In The Treatment Of Nonalcoholic Fatty Liver Disease

NAFLD is the most common liver disease in the Western world and its incidenceis increasing rapidly in our country. It ranges from simple hepatic steatosis throughNASH to variable degrees of fibrosis, cirrhosis and even hepatocellular carcinoma. Itrepresents the hepatic manifestation of the MS. NAFLD is closely related to obesity、T2DM and CVD morbidity and mortality. NAFLD is one of the most common liverdiseases in the Western hemisphere, affecting20%to30%of the adult population.Approximately10%to25%patients with NAFLD can progress to NASH and10%to15%patients with NASH develop hepatocellular carcinoma. Insulin resistance isnearly universal in NAFLD and it is believed to play a crucial role in thepathogenesis of NAFLD. In adipocytes, insulin resistance results in increased activityof hormone-sensitive lipase, which results in lipolysis of triglycerides and release offree fatty acids into circulation. Fatty acids taken up by hepatocytes from circulationand produced by de novo lipogenesis undergo esterification resulting in hepatocytessteatosis. Lifestyle intervention remains the cornerstone of treatment in NAFLD.Weight loss of5%is believed to improve steatosis, whereas10%weight loss isnecessary to improve steatohepatitis. In recent years, therapies against NAFLDreceived many achievements, but these treatments at the exploration stage. They still need further tests and investigations in clinical human trials and animalexperiments.