Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medykow 18, 40-752 Katowice, Poland.
Medicina (Kaunas). 2023 Oct 8;59(10):1789. doi: 10.3390/medicina59101789.
Metabolic-associated Fatty Liver Disease is one of the outstanding challenges in gastroenterology. The increasing incidence of the disease is undoubtedly connected with the ongoing obesity pandemic. The lack of specific symptoms in the early phases and the grave complications of the disease require an active approach to prompt diagnosis and treatment. Therapeutic lifestyle changes should be introduced in a great majority of patients; but, in many cases, the adherence is not satisfactory. There is a great need for an effective pharmacological therapy for Metabolic-Associated Fatty Liver Disease, especially before the onset of steatohepatitis. Currently, there are no specific recommendations on the selection of drugs to treat liver steatosis and prevent patients from progression toward more advanced stages (steatohepatitis, cirrhosis, and cancer). Therefore, in this Review, we provide data on the clinical efficacy of therapeutic interventions that might improve the course of Metabolic-Associated Fatty Liver Disease. These include the drugs used in the treatment of obesity and hyperlipidemias, as well as affecting the gut microbiota and endocrine system, and other experimental approaches, including functional foods. Finally, we provide advice on the selection of drugs for patients with concomitant Metabolic-Associated Fatty Liver Disease.
代谢相关性脂肪性肝病是消化病学领域面临的重大挑战之一。随着肥胖症的流行,该病发病率不断增高。由于该病早期阶段缺乏特异性症状且病情严重,因此需要积极采取措施进行早期诊断和治疗。大多数患者都需要进行生活方式治疗,但在许多情况下,其治疗依从性并不理想。代谢相关性脂肪性肝病需要有效的药物治疗,尤其是在肝脂肪性肝炎发生之前。目前,对于治疗肝脂肪变性和预防疾病进展(肝脂肪性肝炎、肝硬化和肝癌)的药物选择尚无具体建议。因此,在本篇综述中,我们提供了可能改善代谢相关性脂肪性肝病病程的治疗干预措施的临床疗效数据。这些措施包括治疗肥胖症和高脂血症的药物,以及影响肠道菌群和内分泌系统的药物,还有其他一些实验方法,包括功能性食品。最后,我们就合并代谢相关性脂肪性肝病患者的药物选择提供了建议。