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We performed a study to examine the association between diet quality and nonalcoholic fatty liver disease (NAFLD). Our study included 3,586 women aged 40-64 years who participated in the sixth Korea National Health and Nutrition Examination Survey. The study subjects were classified into the NAFLD group (n=816) and the normal group (n=2,770) using the hepatic steatosis index. The anthropometric indices, blood profiles, and dietary intake data of the subjects were obtained. The waist circumference, body mass index, and the serum levels of triglycerides, fasting blood sugar, HbA1c, and systolic and diastolic blood pressures were higher in the NAFLD compared to the normal groups (p<0.001, respectively). The intakes of protein (g/kg body weight, p<0.001), potassium (p<0.001), and vitamin A (p=0.006) were significantly lower in the NAFLD group. It was observed that the higher the total Korean Healthy Eating Index score, the lower the risk of NAFLD. A reverse relationship was shown between the NAFLD risk and the intakes of total fruits, total vegetables, vegetables excluding Kimchi and pickled vegetables, meat, fish, eggs and beans. Therefore, it is recommended that middle- aged women in Korea increase their intakes of fruits, vegetables, and foods high in protein for the proper management of NAFLD. [ABSTRACT FROM AUTHOR]

The prevalence of non-alcoholic fatty liver disease (NAFLD) has sharply increased over the past several decades in Korea. In most cases of NAFLD, metabolic stress and cellular apoptosis are often driven by metabolic abnormality, eventually leading to inflammation and fibrosis . Along with a dramatic surge in the obesity epidemic, 10-20% of NAFLD patients ultimately progress to non-alcoholic steatohepatitis (NASH), a precursor to cirrhosis and hepatocellular carcinoma, as well as multi-organ systemic diseases. Currently, diet and exercise are chiefly recommended to achieve significant weight loss and improve metabolic dysfunction in patients with NAFLD. However, weight loss remains to be an elusive goal for both clinical practitioners and NAFLD patients. To date, although there has not been any proven pharmacotherapy against NAFLD, numerous promising pipelines with good target engagement are under development. Moreover, given the global landmark phase 3 trials using obeticholic acid (a farnesoid X receptor agonist, REGENERATE trial) and elafibranor (a dual peroxisome proliferator-activated receptor α/δ agonist, RESOLVE-IT trial), the era of specific target therapies focusing on molecular and metabolic pathogenesis of NASH and fibrosis is near at hand. In this paper, we briefly cover the current and future therapeutic options in patients with NAFLD across the entire spectrum of diseases.

BackgroundIncreased serum ferritin and decreased vitamin D levels associated with nonalcoholic fatty liver disease (NAFLD). However, their association with the severity of NAFLD has not been fully evaluated. The aim of this study was to compare the association of serum ferritin and 25(OH)D3 levels with the severity of ultrasonographically detected NAFLD (US-NAFLD) and hepatic steatosis defined by fatty liver index (FLI) in Korean adults.MethodsA cross-sectional analysis of clinical and anthropometric data, including serum ferritin and 25(OH)D3, from men (n=295) and women (n=263) who underwent a routine health check-up in 2012.ResultsIn men, with an increase in the quartile of serum ferritin level, the incidences of subjects with metabolic syndrome (P=0.002), US-NAFLD (P=0.041), and FLI ≥60 (P=0.010) were significantly elevated. In women, the incidence of subjects with US-NAFLD was also significantly elevated with increases in the serum ferritin quartile (P=0.012). Regarding 25(OH)D3, no statistical differences were observed among the different quartiles in either gender. Serum ferritin level significantly increased as the severity of US-NAFLD increased (P

Nonalcoholic fatty liver disease (NAFLD) is a common condition that may progress to end-stage liver disease. Recently, NAFLD has been recognized as a hepatic manifestation of metabolic syndrome and an independent risk factor for cardiovascular disease. Therefore, appropriate management of this common disorder is an important public health issue. The management of NAFLD is based on gradual weight loss through lifestyle modification. Reducing total calorie intake and carbohydrates in the diet is beneficial for NAFLD patients. Regular exercise reduces hepatic fat content independent of weight loss. However, such lifestyle changes are difficult to maintain long term for most patients. Despite the growing need for pharmacologic therapy, there is currently no effective agent for the treatment of NAFLD. Several large clinical trials have shown promising but inconsistent effects of pioglitazone and vitamin E for improving NAFLD. However, larger clinical trials are required before definitive conclusions can be drawn. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is more prevalent in diabetic patients than in non-diabetic subjects, because the two diseases share a common pathophysiological mechanism. Associated abnormalities can be observed from the pre-diabetic stage. Lifestyle intervention, including diet, exercise, and weight loss, is the primary recommended therapy for NAFLD. Among the therapeutic drugs for NAFLD treatment, anti-diabetic agents are aimed at improving or slowing the progression of NAFLD in addition to lowering blood glucose. In this paper, we systemically review the evidence surrounding antidiabetic medications and their ability to improve disease progression in patients with NAFLD. [ABSTRACT FROM AUTHOR]

In the management and treatment of nonalcoholic fatty liver disease (NAFLD) ranging from hepatic steatosis (HS) to nonalcoholic steatohepatitis (NASH), the goals in patients without NASH or hepatic fibrosis are weight reduction through lifestyle modification such as nutritional and exercise intervention and control of associated metabolic morbidities including obesity, metabolic syndrome, and type 2 diabetes. Weight reduction of at least 3% to 5% could improve steatosis, and the characteristics of NASH histopathology with a dose-response curve between the degree of weight loss and improvement of histopathology. The patients with NAFLD could achieve weight reduction with hypocaloric diet with or without exercise, but not with exercise alone. Despite the absence of a weight loss effect of exercise alone, it may prevent or alleviate HS and associated metabolic parameters. [ABSTRACT FROM AUTHOR]

Obesity has reached epidemic proportions in the world. Nonalcoholic fatty liver disease (NAFLD) affects around one-third of Western countries, with an incidence that continues to also increase in other parts of the world, especially in Asia. NAFLD is frequently associated with obesity, type 2 diabetes mellitus, and dyslipidemia. Epidemiologic studies show that obesity and insulin resistance are the most prevalent risk factors for NAFLD, and insulin resistance is an essential requirement for the development of NAFLD. Hyperinsulinemia directly promotes fat accumulation in hepatocytes. In addition, the pathogenesis of hepatic steatosis is complex, with visceral fat, adipokines, and inflammatory cytokines such as IL-6 and TNF-α all appearing to be involved to some extent. An alternative hypothesis is that excess triglycerides in the liver may cause insulin resistance. NAFLD can promote lipotoxicity and adipose tissue inflammation and can influence development of insulin resistance. Thus, insulin resistance should be taken into consideration to elucidate the pathogenesis of NAFLD. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is a chronic condition characterized by fat accumulation combined with low-grade inflammation in the liver. A large body of clinical and experimental data shows that an increased flux of free fatty acids from increased visceral adipose tissue can lead to NAFLD and insulin resistance. Thus, patients with obesity, insulin resistance, and dyslipidemia are at the greatest risk for NAFLD. Many people believe NAFLD is one of the phenotypes of metabolic syndrome or insulin resistance. In the United States, NAFLD prevalence was reported to be approximately 34% in the adult population. In previous studies performed in Korea, NAFLD prevalence varied from 17.9% to 27.4%, depending on the study populations and diagnostic methods. Prevalence of NAFLD confirmed by liver biopsy was 51.4% in living liver donors in Korea. Recent data showed that NAFLD prevalence was 27.3% (38.3% in men and 12.6% in women) among 161,891 Seoul and Gyeonggi-province residents receiving a health examination from January 2009 to December 2010. Insulin resistance is a major feature and pathogenic factor of NAFLD. Theoretically, genetic variation in candidate genes related to insulin resistance may contribute to the pathogenesis of NAFLD. A recent genetic study using the significance analysis of microarrays method reported that 21 candidate genes, from a pool containing thousands of genes, were involved in NAFLD and insulin resistance. Comprehensive investigation of common genes that are potentially pathogenic in the development of NAFLD is warranted. [ABSTRACT FROM AUTHOR]

Purpose: This study was intended to analyze the types and measurement parameters of non-pharmacological interventional studies for nonalcoholic fatty liver disease (NAFLD). Methods: NAFLD related literatures were systematically reviewed. The existing literatures were searched electronically using the data base of PubMed, a Medline data base of the National Library of Medicine with the key words of nonalcoholic fatty liver disease, NAFLD, nonalcoholic steatohepatitis, and NASH. The criteria for inclusion in this review were 1) non-pharmacological intervention, 2) human, 3) English. Finally, 20 articles were included in the review. Results: The major findings of this study were as follows: 1) the types of non-pharmacological intervention were exercise (35%), caloric restriction (30%), and lifestyle modification with combination both of exercise and caloric restriction (35%), 2) Almost all studies adopted various measurement parameters derived from pathophysiological mechanism-based biomarkers such as anthropometric indices, biochemical parameters, body fat mass, and liver biopsy results. Conclusion: Non-pharmacological interventions have been reported to be effective to improve NAFLD status, and many objective biomarkers confirmed supported these findings. Therefore, the development of nursing interventions for NAFLD subjects is needed and the consideration of using mechanism-based biomarkers is suggested to verify nursing outcomes objectively. [ABSTRACT FROM AUTHOR]

The prevalence of non-alcoholic fatty liver disease (NAFLD) has sharply increased over the past several decades in Korea. In most cases of NAFLD, metabolic stress and cellular apoptosis are often driven by metabolic abnormality, eventually leading to inflammation and fibrosis . Along with a dramatic surge in the obesity epidemic, 10-20% of NAFLD patients ultimately progress to non-alcoholic steatohepatitis (NASH), a precursor to cirrhosis and hepatocellular carcinoma, as well as multi-organ systemic diseases. Currently, diet and exercise are chiefly recommended to achieve significant weight loss and improve metabolic dysfunction in patients with NAFLD. However, weight loss remains to be an elusive goal for both clinical practitioners and NAFLD patients. To date, although there has not been any proven pharmacotherapy against NAFLD, numerous promising pipelines with good target engagement are under development. Moreover, given the global landmark phase 3 trials using obeticholic acid (a farnesoid X receptor agonist, REGENERATE trial) and elafibranor (a dual peroxisome proliferator-activated receptor α/δ agonist, RESOLVE-IT trial), the era of specific target therapies focusing on molecular and metabolic pathogenesis of NASH and fibrosis is near at hand. In this paper, we briefly cover the current and future therapeutic options in patients with NAFLD across the entire spectrum of diseases.