Management of Non-alcoholic Fatty Liver Disease / 임상당뇨병

ABSTRACT

Non-alcoholic fatty liver disease (NAFLD) is a common condition that may progress to end-stage liver disease. Recently, it has been recognized as a hepatic manifestation of metabolic syndrome and an independent risk factor for cardiovascular disease. Therefore, managing this common disorder is becoming 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 life style changes are known to be difficult to maintain in the 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 in improving NAFLD. Trials with ursodeoxycholic acid or metformin have been disappointing.Recently, promising evidence has shown that incretin-based therapies may improve NAFLD. Larger clinical trials are required before a definite conclusion can be made.