Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298-0341, USA.
J Gastroenterol Hepatol. 2012 Mar;27 Suppl 2(Suppl 2):58-64. doi: 10.1111/j.1440-1746.2011.07018.x.
Nonalcoholic fatty liver disease is a spectrum that ranges from benign steatosis to steatohepatitis. It has become the most common cause of chronic liver disease, and yet there continues to be a lack of effective therapeutic options. This article reviews current concepts underlying the pathophysiological basis of nonalcoholic steatohepatitis from development of insulin resistance to the establishment of fibrosis. Then using a physiology-based approach, specific targeted therapeutics are reviewed along with their drawbacks. The evidence behind current therapies is based predominantly on small trials and, thus, no recommendations can be made until larger randomized trials are conducted.
非酒精性脂肪性肝病是一个谱，从良性脂肪变性到脂肪性肝炎。它已成为最常见的慢性肝病的原因，但仍然缺乏有效的治疗方法。本文从胰岛素抵抗的发展到纤维化的建立，综述了非酒精性脂肪性肝炎的病理生理学基础的当前概念。然后，使用基于生理学的方法，综述了特定的靶向治疗及其缺点。目前治疗的证据主要基于小的临床试验，因此，在进行更大的随机试验之前，不能做出任何建议。
