Chaudhry Ahtshamullah, Noor Jawad, Batool Saima, Fatima Ghulam, Noor Riwad
Internal Medicine, St. Dominic Hospital, Jackson, USA.
Pathology, Nishtar Medical University, Multan, PAK.
Cureus. 2023 Sep 8;15(9):e44924. doi: 10.7759/cureus.44924. eCollection 2023 Sep.
Non-alcoholic fatty liver disease (NAFLD) is one of the most common diseases of the liver globally. Non-alcoholic steatohepatitis (NASH) has a complicated pathophysiology which includes lipid buildup, oxidative stress, endoplasmic reticulum stress, and lipotoxicity. Recently, there has been tremendous improvement in understanding of NASH pathogenesis due to advancements in the scientific field. It is being investigated how non-invasive circulating and imaging biomarkers can help in NAFLD and NASH diagnosis and monitoring the progress. Multiple medications are now undergoing clinical trials for the treatment of NASH, and lifestyle changes have been acknowledged as one of the main treatment methods. The purpose of this review article is to discuss the incidence of NAFLD globally, management issues with NASH, and its relation to the metabolic syndrome. It explains pathophysiology as well as therapeutic strategies using natural items, dietary changes, and pharmaceutical treatments. While emphasizing the necessity for surrogate endpoints to facilitate medication development for NASH, the study also considers the potential of non-invasive imaging biomarkers including magnetic resonance imaging (MRI) and magnetic resonance elastography (MRE).
非酒精性脂肪性肝病(NAFLD)是全球最常见的肝脏疾病之一。非酒精性脂肪性肝炎(NASH)具有复杂的病理生理学,包括脂质堆积、氧化应激、内质网应激和脂毒性。近年来,由于科学领域的进展,对NASH发病机制的认识有了巨大进步。目前正在研究非侵入性循环和成像生物标志物如何有助于NAFLD和NASH的诊断以及监测病情进展。目前有多种药物正在进行治疗NASH的临床试验,生活方式的改变已被公认为主要治疗方法之一。这篇综述文章的目的是讨论全球NAFLD的发病率、NASH的管理问题及其与代谢综合征的关系。文章解释了病理生理学以及使用天然物质、饮食改变和药物治疗的治疗策略。在强调替代终点对促进NASH药物开发的必要性的同时,该研究还考虑了包括磁共振成像(MRI)和磁共振弹性成像(MRE)在内的非侵入性成像生物标志物的潜力。