Non-Alcoholic Fatty Liver Disease

Authors

Abstract

Non-alcoholic fatty liver disease (NAFLD) is characterized by the buildup of fat in the liver, and it is not caused by excessive alcohol consumption. NAFLD is highly prevalent, affecting approximately 30% of the population in developed countries and around 10% in developing nations. As a result, NAFLD has become the most prevalent liver condition worldwide.

The development of NAFLD is closely linked to insulin resistance, making it common among individuals who have central obesity or diabetes. Insulin resistance and excess body fat contribute to a higher influx of lipids into the liver and an increased production of new fats within the liver, known as de novo hepatic lipogenesis. These processes ultimately lead to the accumulation of triglycerides in the liver, a characteristic feature of NAFLD.

NAFLD is closely associated with components of the metabolic syndrome, and individuals with type 2 diabetes have an increased risk of developing cirrhosis and its related complications. While cardiovascular disease and extra hepatic malignancy are the leading causes of death in people with NAFLD, the presence of advanced liver fibrosis is a significant indicator of liver-related outcomes and overall mortality. Non-invasive tests that combine various methods can be used to assess the extent of liver fibrosis. Patients diagnosed with cirrhosis should undergo screenings for hepatocellular carcinoma (a type of liver cancer) and esophageal varices. Currently, there are no approved therapies for NAFLD; however, there are several drugs in advanced stages of development that show promise for future treatment options.

Keywords: Non-alcoholic fatty liver disease, Weight management, Bariatric surgery,  Metabolic surgery, Conservative therapy.

Keywords:

Non-alcoholic fatty liver disease, Weight management, Bariatric surgery, Metabolic surgery, Conservative therapy

DOI

https://doi.org/10.22270/jddt.v13i10.6226

Author Biographies

Tadikonda Rama Rao, Professor & Principal, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

Professor & Principal, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India

B. Pratiksha, Department of Pharm. D, CMR College of Pharmacy, Kandlokoya, Medchal, Telangana, India.

Department of Pharm. D, CMR College of Pharmacy, Kandlokoya, Medchal, Telangana, India.

C. Navyasri, Department of Pharm. D, CMR College of Pharmacy, Kandlokoya, Medchal, Telangana, India.

Department of Pharm. D, CMR College of Pharmacy, Kandlokoya, Medchal, Telangana, India.

Dwip Jyoti Kalita, Department of Pharm. D, CMR College of Pharmacy, Kandlokoya, Medchal, Telangana, India.

Department of Pharm. D, CMR College of Pharmacy, Kandlokoya, Medchal, Telangana, India.

Shahzad Alam, Department of Pharm. D, CMR College of Pharmacy, Kandlokoya, Medchal, Telangana, India.

Department of Pharm. D, CMR College of Pharmacy, Kandlokoya, Medchal, Telangana, India.

References

Briohny W, Smith LA. Non-alcoholic fatty liver disease. Critical reviews in clinical laboratory sciences. 2011;48(3):97–113.

Elizabeth E, Powell V, Wong M. Non-alcoholic fatty liver disease. The lancet. 2021;2212–24.

Sanyal AJ, Brunt EM, Kleiner DE, Kowdley KV, Chalasani N, Lavine JE, et al. Endpoints and clinical trial design for nonalcoholic steatohepatitis. Hepatology [Internet]. 2011;54(1):344–53. Available from: http://dx.doi.org/10.1002/hep.24376

Ahmed A, Wong RJ, Harrison SA. Nonalcoholic fatty liver disease review: Diagnosis, treatment, and outcomes. Clin Gastroenterol Hepatol [Internet]. 2015;13(12):2062–70. Available from: http://dx.doi.org/10.1016/j.cgh.2015.07.029

Machado MV, Diehl AM. Pathogenesis of nonalcoholic steatohepatitis. Gastroenterology [Internet]. 2016;150(8):1769–77. Available from: http://dx.doi.org/10.1053/j.gastro.2016.02.066

Nasr P, Ignatova S, Kechagias S, Ekstedt M. Natural history of nonalcoholic fatty liver disease: a prospective follow-up study with serial biopsies: Hepatol Commun. Hepatol Commun. 2018;2(2):199–210.

Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol [Internet]. 2018;15(1):11–20. Available from: http://dx.doi.org/10.1038/nrgastro.2017.109

Younossi ZM, Golabi P, de Avila L, Paik JM, Srishord M, Fukui N, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis. J Hepatol [Internet]. 2019;71(4):793–801. Available from: http://dx.doi.org/10.1016/j.jhep.2019.06.021

Angulo P, Kleiner DE, Dam-Larsen S, Adams LA, Bjornsson ES, Charatcharoenwitthaya P, et al. Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology [Internet]. 2015;149(2):389-397.e10. Available from: http://dx.doi.org/10.1053/j.gastro.2015.04.043

Ekstedt M, Hagstrom H, Nasr P, Fredrikson M, Stal P, Kechagias S. Fibrosis stage is the strongest predictor for disease- specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61(5):1547–54.

Estes C, Razavi H, Loomba R, Younossi Z, Sanyal AJ. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease: Estes et al. Hepatology [Internet]. 2018;67(1):123–33. Available from: http://dx.doi.org/10.1002/hep.29466

Lonardo A, Nascimbeni F, Maurantonio M, Marrazzo A, Rinaldi L, Adinolfi LE. Nonalcoholic fatty liver disease: Evolving paradigms. World J Gastroenterol [Internet]. 2017;23(36):6571–92. Available from: http://dx.doi.org/10.3748/wjg.v23.i36.6571

Acierno C, Caturano A, Pafundi PC, Nevola R, Sasso ALE. C: Nonalcoholic fatty liver disease and type 2 diabetes: Pathophysiological mechanisms shared between the two faces of the same coin. Explor Med. 2020;1:287–306.

Edmison J, Mccullough AJ. Pathogenesis of non-alcoholic steatohepatitis: human data Clin Liver Dis. 2007;11:75–104.

Day CP, Saksena S. Non-alcoholic steatohepatitis: definitions and pathogenesis. J Gastroenterol Hepatol. 2002;17 Suppl 3:S377-84.

Chitturi S, Farrell GC. Etiopathogenesis of nonalcoholic steatohepatitis. Semin Liver Dis [Internet]. 2001;21(1):27–41. Available from: http://dx.doi.org/10.1055/s-2001-12927

Fromenty B, Pessayre D. Impaired mitochondrial function in microvesicular steatosis. Efects of drugs, ethanol, hormones and cytokines. J Hepatol. 1997;26(2):43–53.

Bril F, Cusi K. Management of nonalcoholic fatty liver disease in patients with type 2 diabetes: A call to action. Diabetes Care [Internet]. 2017;40(3):419–30. Available from: http://dx.doi.org/10.2337/dc16-1787

Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology [Internet]. 2011;140(1):124–31. Available from: http://dx.doi.org/10.1053/j.gastro.2010.09.038

Dai W, Ye L, Liu A, Wen SW, Deng J, Wu X, et al. Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: A meta-analysis: A meta-analysis. Medicine (Baltimore) [Internet]. 2017;96(39):e8179. Available from: http://dx.doi.org/10.1097/MD.0000000000008179

Portillo P, Yavuz S, Bril F, Cusi K. Role of insulin resistance and diabetes in the pathogenesis and treatment of nonalcoholic fatty liver disease. Curr Hepatol Rep [Internet]. 2014;13(2):159–70. Available from: http://dx.doi.org/10.1007/s11901-014-0229-3

Lonardo A, Bellentani S, Byrne CD, Cortez-Pinto CSH, Grieco H, Machado A, et al. Epidemiological modifiers of non-alcoholic fatty liver disease: Non-Alcoholic Fatty Liver Disease Study Group. 2015;47:997–1006.

Inchiostro S, Bertoli G, Zanette G, Donadon V. Evidence of higher insulin resistance in NIDDM patients with ischaemic heart disease. Diabetologia [Internet]. 1994;37(6):597–603. Available from: http://dx.doi.org/10.1007/s001250050153

Torella D, Ellison GM, Torella M, Vicinanza C, Aquila I, Iaconetti C, et al. C: Carbonic anhydrase activation is associated with worsened pathological remodeling in human ischemic diabetic cardiomyopathy. J Am Heart Assoc. 2014;

Marfella R, Sasso FC, Siniscalchi M, Paolisso P, Rizzo MR, Ferraro F, et al. Peri-procedural tight glycemic control during early percutaneous coronary intervention is associated with a lower rate of in-stent restenosis in patients with acute ST-elevation myocardial infarction. J Clin Endocrinol Metab [Internet]. 2012;97(8):2862–71. Available from: http://dx.doi.org/10.1210/jc.2012-1364

Sasso FC, Rinaldi L, Lascar N, Marrone A, Pafundi PC, Adinolfi LE, et al. Role of tight glycemic control during acute coronary syndrome on CV outcome in type 2 diabetes. J Diabetes Res [Internet]. 2018;2018:3106056. Available from: http://dx.doi.org/10.1155/2018/3106056

Zhou Y-Y, Zhou X-D, Wu S-J, Hu X-Q, Tang B, van Poucke S, et al. Synergistic increase in cardiovascular risk in diabetes mellitus with nonalcoholic fatty liver disease: a meta-analysis. Eur J Gastroenterol Hepatol [Internet]. 2018;30(6):631–6. Available from: http://dx.doi.org/10.1097/MEG.0000000000001075

Bacon BR, Farahvash MJ, Janney CG, Neuschwander-Tetri BA. Nonalcoholic steatohepatitis: an expanded clinical entity. Gastroenterology [Internet]. 1994;107(4):1103–9. Available from: http://dx.doi.org/10.1016/0016-5085(94)90235-6

Bhatia LS, Curzen NP, Calder PC, Byrne CD. Non-alcoholic fatty liver disease: a new and important cardiovascular risk factor? Eur Heart J [Internet]. 2012;33(10):1190–200. Available from: http://dx.doi.org/10.1093/eurheartj/ehr453

Targher G, Bertolini L, Poli F, Rodella S, Scala L, Tessari R, et al. Nonalcoholic fatty liver disease and risk of future cardiovascular events among type 2 diabetic patients. Diabetes [Internet]. 2005;54(12):3541–6. Available from: http://dx.doi.org/10.2337/diabetes.54.12.3541

Ou H, Fu Y, Liao W, Zheng C, Wu X. Association between smoking and liver fibrosis among patients with nonalcoholic fatty liver disease. Can J Gastroenterol Hepatol [Internet]. 2019;2019:1–5. Available from: http://dx.doi.org/10.1155/2019/6028952

Targher G, Bertolini L, Padovani R, Rodella S, Tessari R, Zenari L, et al. Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes Care [Internet]. 2007;30(5):1212–8. Available from: http://dx.doi.org/10.2337/dc06-2247

Lonardo A, Sookoian S, Pirola CJ, Targher G. Non-alcoholic fatty liver disease and risk of cardiovascular disease. Metabolism [Internet]. 2016;65(8):1136–50. Available from: http://dx.doi.org/10.1016/j.metabol.2015.09.017

Hamabe A, Uto H, Imamura Y, Kusano K, Mawatari S, Kumagai K, et al. Impact of cigarette smoking on onset of nonalcoholic fatty liver disease over a 10-year period. J Gastroenterol [Internet]. 2011;46(6):769–78. Available from: http://dx.doi.org/10.1007/s00535-011-0376-z

Machado MV, Michelotti GA, Pereira TA, Xie G, Premont R, Cortez-Pinto H, et al. Accumulation of duct cells with activated YAP parallels fibrosis progression in non-alcoholic fatty liver disease. J Hepatol [Internet]. 2015;63(4):962–70. Available from: http://dx.doi.org/10.1016/j.jhep.2015.05.031

Published

15-10-2023
Statistics
Abstract Display: 235
PDF Downloads: 150
PDF Downloads: 21

How to Cite

1.
Rama Rao T, Pratiksha B, Navyasri C, Kalita DJ, Alam S. Non-Alcoholic Fatty Liver Disease. J. Drug Delivery Ther. [Internet]. 2023 Oct. 15 [cited 2025 Feb. 13];13(10):149-53. Available from: https://jddtonline.info/index.php/jddt/article/view/6226

How to Cite

1.
Rama Rao T, Pratiksha B, Navyasri C, Kalita DJ, Alam S. Non-Alcoholic Fatty Liver Disease. J. Drug Delivery Ther. [Internet]. 2023 Oct. 15 [cited 2025 Feb. 13];13(10):149-53. Available from: https://jddtonline.info/index.php/jddt/article/view/6226