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• W2566651847 startingPage "745" @default.
• W2566651847 abstract "Non-alcoholic fatty liver disease (NAFLD) is characterized by intrahepatic fat accumulation with varying degrees of hepatic inflammation and fibrosis. It is widely prevalent (20–30%) in industrialized societies and is also increasing in Asia. It has strong ties with obesity and type 2 diabetes and is recognized as the hepatic manifestation of prediabetes and the metabolic syndrome. The outcome of NAFLD is influenced by the histologic subtype and varies from benign (simple steatosis) to progressive in some cases (non-alcoholic steatohepatitis) or invariable decline into hepatic failure (cirrhosis). Patients with type 2 diabetes are over-represented among those with adverse outcomes, and NASH is particularly common during prediabetes: the rate of new diagnosis of diabetes is increased three- to fivefold during the next five years. Cardiovascular, extra and intra- and extra-hepatic malignancy and liver failure are the main causes of death. An emerging concern is the risk of hepatocellular carcinoma even in individuals without cirrhosis. Of the many pathways involved in the transition from steatosis to NASH, lipotoxicity (especially from free cholesterol) causing hepatocyte injury with recruitment of inflammation via pattern recognition receptors (Toll-like receptors, the NLRP3 inflammasome) is the leading contender. Lifestyle measures, involving exercise and weight reduction, and optimizing diabetes, blood pressure and lipid control are the principal objectives of management. Agents that improve glycemic control via the gut–beta-cell axis show promise against NAFLD and NASH. Drugs directed specifically at NASH, such as vitamin E can improve steatohepatitis but complete resolution of NASH and resolution of fibrosis remains an elusive goal. Liver transplantation is indicated for those with hepatic decompensation, but eventual poor cardiovascular outcomes are more likely than for other liver indications." @default.
• W2566651847 created "2017-01-06" @default.
• W2566651847 creator A5074255400 @default.
• W2566651847 creator A5076090034 @default.
• W2566651847 date "2016-12-09" @default.
• W2566651847 modified "2023-10-14" @default.
• W2566651847 title "Diabetes and Non‐Alcoholic Fatty Liver Disease" @default.
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