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非酒精性脂肪性肝病(NAFLD)治疗的新进展

What's New in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD).

作者信息

Kosmalski Marcin, Frankowski Rafał, Ziółkowska Sylwia, Różycka-Kosmalska Monika, Pietras Tadeusz

机构信息

Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland.

Students' Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland.

出版信息

J Clin Med. 2023 Feb 26;12(5):1852. doi: 10.3390/jcm12051852.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a serious health problem due to its high incidence and consequences. In view of the existing controversies, new therapeutic options for NAFLD are still being sought. Therefore, the aim of our review was to evaluate the recently published studies on the treatment of NAFLD patients. We searched for articles in the PubMed database using appropriate terms, including "non-alcoholic fatty liver disease", "nonalcoholic fatty liver disease", "NAFLD", "diet", "treatment", "physical activity", "supplementation", "surgery", "overture" and "guidelines". One hundred forty-eight randomized clinical trials published from January 2020 to November 2022 were used for the final analysis. The results show significant benefits of NAFLD therapy associated with the use of not only the Mediterranean but also other types of diet (including low-calorie ketogenic, high-protein, anti-inflammatory and whole-grain diets), as well as enrichment with selected food products or supplements. Significant benefits in this group of patients are also associated with moderate aerobic physical training. The available therapeutic options indicate, above all, the usefulness of drugs related to weight reduction, as well as the reduction in insulin resistance or lipids level and drugs with anti-inflammatory or antioxidant properties. The usefulness of therapy with dulaglutide and the combination of tofogliflozin with pioglitazone should be emphasized. Based on the results of the latest research, the authors of this article suggest a revision of the therapeutic recommendations for NAFLD patients.

摘要

非酒精性脂肪性肝病(NAFLD)因其高发病率和后果而成为一个严重的健康问题。鉴于现有的争议,仍在寻找NAFLD的新治疗选择。因此,我们综述的目的是评估最近发表的关于NAFLD患者治疗的研究。我们在PubMed数据库中使用适当的检索词搜索文章,包括“非酒精性脂肪性肝病”、“非酒精性脂肪肝”、“NAFLD”、“饮食”、“治疗”、“体育活动”、“补充剂”、“手术”、“序曲”和“指南”。最终分析使用了2020年1月至2022年11月发表的148项随机临床试验。结果表明,NAFLD治疗不仅与地中海饮食有关,还与其他类型的饮食(包括低热量生酮饮食、高蛋白饮食、抗炎饮食和全谷物饮食)以及某些食品或补充剂的添加有关,都具有显著益处。在这组患者中,中度有氧运动训练也具有显著益处。现有的治疗选择首先表明,与减轻体重、降低胰岛素抵抗或血脂水平相关的药物以及具有抗炎或抗氧化特性的药物是有用的。应强调度拉糖肽治疗以及托格列净与吡格列酮联合使用的有效性。基于最新研究结果,本文作者建议对NAFLD患者的治疗建议进行修订。

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