El Hígado graso (parte 2): enfoque clínico y tratamiento
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https://doi.org/10.22516/25007440.979Palabras clave:
Hígado graso, diagnostico no invasivo, enfoque clínico, tratamientoResumen
Los pacientes con hígado graso son casi siempre asintomáticos, las aminotransferasas usualmente están elevadas dos a cinco veces el valor normal y son una causa importante de consulta inicial. Todas las imágenes pueden evidenciar el hígado graso y la biopsia hepática sigue siendo la prueba de oro para su diagnóstico. En cualquier paciente las pruebas no invasivas son una excelente alternativa a la biopsia para determinar el grado de fibrosis hepática y establecer en qué etapa de la fibrogénesis se encuentra. La pérdida de peso y el ejercicio son los pilares fundamentales del tratamiento indicado para todos los pacientes con sobrepeso u obesidad; se recomienda una pérdida de peso entre 5% y 10% del peso corporal y una dieta con restricción calórica de 500-1000 kcal/día, baja en grasas saturadas y rica en productos de la dieta mediterránea como fruta, pescado, verduras, frutos secos, aceite de oliva, entre otros. Hay otros tratamientos como las medidas farmacológicas y los procedimientos endoscópicos y quirúrgicos.
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Referencias bibliográficas
Patel V, Sanyal AJ, Sterling R. Clinical Presentation and Patient Evaluation in Nonalcoholic Fatty Liver Disease. Review Clin Liver Dis. 2016;20(2):277-92. https://doi.org/10.1016/j.cld.2015.10.006
Arun J, Clements RH, Lazenby AJ, Leeth RR, Abrams GA. The prevalence of nonalcoholic steatohepatitis is greater in morbidly obese men compared to women. Obes Surg 2006;16(10):1351-8. https://doi.org/10.1381/096089206778663715
Amarapurkar D, Kamani P, Patel N, Gupte P, Kumar P, Agal S, et al. Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6(3):161-3. https://doi.org/10.1016/S1665-2681(19)31922-2
Browning JD, Szczepaniak LS, Dobbins R, Nuremberg P, Horton JD, Cohen JC, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004;40(6):1387-95. https://doi.org/10.1002/hep.20466
Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology. 1999;30(6):1356-62. https://doi.org/10.1002/hep.510300604
Mofrad P, Contos MJ, Haque M, Sargeant C, Fisher RA, Luketic VA, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology. 2003;37(6):1286-92. https://doi.org/10.1053/jhep.2003.50229
Noguchi H, Tazawa Y, Nishinomiya F, Takada G. The relationship between serum transaminase activities and fatty liver in children with simple obesity. Acta Paediatr Jpn. 1995;37(5):621-5. https://doi.org/10.1111/j.1442-200X.1995.tb03389.x
Charatcharoenwitthaya P, Lindor KD, Angulo P. The spontaneous course of liver enzymes and its correlation in nonalcoholic fatty liver disease. Dig Dis Sci. 2012;57(7):1925-31. https://doi.org/10.1007/s10620-012-2098-3
Neuschwander-Tetri BA, Clark JM, Bass NM, Van Natta ML, Unalp-Arida A, Tonascia J, et al. Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease. Hepatology. 2010;52(3):913-24. https://doi.org/10.1002/hep.23784
Kowdley KV, Belt P, Wilson LA, Yeh MM, Neuschwander-Tetri BA, Chalasani N, et al. Serum ferritin is an independent predictor of histologic severity and advanced fibrosis in patients with nonalcoholic fatty liver disease. Hepatology. 2012;55(1):77-85. https://doi.org/10.1002/hep.24706
Lee SS, Park SH. Radiologic evaluation of nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20(23):7392-402. https://doi.org/10.3748/wjg.v20.i23.7392
Hernaez R, Lazo M, Bonekamp S, Kamel I, Brancati FL, Guallar E, et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54(3):1082-1090. https://doi.org/10.1002/hep.24452
Mottin CC, Moretto M, Padoin AV, Swarowsky AM, Toneto MG, Glock L, et al. The role of ultrasound in the diagnosis of hepatic steatosis in morbidly obese patients. Obes Surg. 2004;14(5):635-7. https://doi.org/10.1381/096089204323093408
Park SH, Kim PN, Kim KW, Lee SW, Yoon SE, Park SW, et al. Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment. Radiology. 2006;239(1):105-12. https://doi.org/10.1148/radiol.2391050361
Cho CS, Curran S, Schwartz LH, Kooby DA, Klimstra DS, Shia J, et al. Preoperative radiographic assessment of hepatic steatosis with histologic correlation. J Am Coll Surg. 2008;206(3):480-8. https://doi.org/10.1016/j.jamcollsurg.2007.08.020
Borra RJ, Salo S, Dean K, Lautamäki R, Nuutila P, Komu M, et al. Nonalcoholic fatty liver disease: rapid evaluation of liver fat content with in-phase and out-of-phase MR imaging. Radiology. 2009;250(1):130-6. https://doi.org/10.1148/radiol.2501071934
Yokoo T, Shiehmorteza M, Hamilton G, Wolfson T, Schroeder ME, Middleton MS, et al. Estimation of hepatic proton-density fat fraction by using MR imaging at 3.0 T. Radiology. 2011;258(3):749-59. https://doi.org/10.1148/radiol.10100659
Dulai PS, Sirlin CB, Loomba R. MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: Clinical trials to clinical practice. J Hepatol. 2016;65(5):1006-1016. https://doi.org/10.1016/j.jhep.2016.06.005
Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-357. https://doi.org/10.1002/hep.29367
European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64(6):1388-402. https://doi.org/10.1016/j.jhep.2015.11.004
Neuschwander-Tetri BA, Clark JM, Bass NM, et al. Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease. Hepatology 2010; 52:913.
Kleiner DE, Brunt EM. Nonalcoholic fatty liver disease: pathologic patterns and biopsy evaluation in clinical research. Semin Liver Dis. 2012;32(1):3-13. https://doi.org/10.1055/s-0032-1306421
Brunt EM, Tiniakos DG. Histopathology of nonalcoholic fatty liver disease. World J Gastroenterol. 2010;16(42):5286-96. https://doi.org/10.3748/wjg.v16.i42.5286
Aller R, Fernández-Rodríguez C, Lo Iacono O, Bañares R, Abad J, Carrión JA, et al. Consensus document. Management of non-alcoholic fatty liver disease (NAFLD). Clinical practice guideline. Gastroenterol Hepatol. 2018;41(5):328-349. https://doi.org/10.1016/j.gastrohep.2017.12.003
Arab JP, Dirchwolf M, Álvares-da-Silva MR, Barrera F, Benítez C, Castellanos-Fernandez M, et al. Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease. Ann Hepatol. 2020;19(6):674-690. https://doi.org/10.1016/j.aohep.2020.09.006
Argo CK, Northup PG, Al-Osaimi AM, Caldwell SH. Systematic review of risk factors for fibrosis progression in non-alcoholic steatohepatitis. J Hepatol. 2009;51(2):371-9. https://doi.org/10.1016/j.jhep.2009.03.019
Vilar-Gomez E, Calzadilla-Bertot L, Wai-Sun Wong V, Castellanos M, Aller-de la Fuente R, Metwally M, et al. Fibrosis Severity as a Determinant of Cause-Specific Mortality in Patients With Advanced Nonalcoholic Fatty Liver Disease: A Multi-National Cohort Study. Gastroenterology. 2018;155(2):443-457.e17. https://doi.org/10.1053/j.gastro.2018.04.034
Ekstedt M, Hagström H, Nasr P, Fredrikson M, Stål P, Kechagias S, et al. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61(5):1547-54. https://doi.org/10.1002/hep.27368
European Association for Study of Liver; Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63(1):237-64. https://doi.org/10.1016/j.jhep.2015.04.006
Cusi K, Isaacs S, Barb D, Basu R, Caprio S, Garvey WT, et al. American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocr Pract. 2022;28(5):528-562. https://doi.org/10.1016/j.eprac.2022.03.010
Lin ZH, Xin YN, Dong QJ, Wang Q, Jiang XJ, Zhan SH, et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Hepatology. 2011;53(3):726-36. https://doi.org/10.1002/hep.24105
Angulo P, Bugianesi E, Bjornsson ES, Charatcharo-enwitthaya P, Mills PR, Barrera F, et al. Simple noninvasive systems predict long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology. 2013;145(4):782-9.e4. https://doi.org/10.1053/j.gastro.2013.06.057
Shah AG, Lydecker A, Murray K, Tetri BN, Contos MJ, Sanyal AJ; et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009;7(10):1104-12. https://doi.org/10.1016/j.cgh.2009.05.033
Angulo P, Hui JM, Marchesini G, Bugianesi E, George J, Farrell GC, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45(4):846-54. https://doi.org/10.1002/hep.21496
Harrison SA, Oliver D, Arnold HL, Gogia S, Neuschwander-Tetri BA. Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease. Gut. 2008;57(10):1441-7. https://doi.org/10.1136/gut.2007.146019
Cichoż-Lach H, Celiński K, Prozorow-Król B, Swatek J, Słomka M, Lach T. The BARD score and the NAFLD fibrosis score in the assessment of advanced liver fibrosis in nonalcoholic fatty liver disease. Med Sci Monit. 2012;18(12):CR735-40. https://doi.org/10.12659/MSM.883601
Ozturk A, Grajo JR, Dhyani M, Anthony BW, Samir AE. Principles of ultrasound elastography. Abdom Radiol (NY). 2018;43(4):773-785. https://doi.org/10.1007/s00261-018-1475-6
Boursier J, Guillaume M, Bouzbib C, Lannes A, Pais R, Smatti S, et al. Non-invasive diagnosis and follow-up of non-alcoholic fatty liver disease. Clin Res Hepatol Gastroenterol. 2022;46(1):101769. https://doi.org/10.1016/j.clinre.2021.101769
Castera L. Non-invasive tests for liver fibrosis in NAFLD: Creating pathways between primary healthcare and liver clinics. Liver Int. 2020;40 Suppl 1:77-81. https://doi.org/10.1111/liv.14347
Xiao H, Shi M, Xie Y, Chi X. Comparison of diagnostic accuracy of magnetic resonance elastography and Fibroscan for detecting liver fibrosis in chronic hepatitis B patients: A systematic review and meta-analysis. PLoS One. 2017;12(11):e0186660. https://doi.org/10.1371/journal.pone.0186660
Castera L, Friedrich-Rust M, Loomba R. Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology. 2019;156(5):1264-1281.e4. https://doi.org/10.1053/j.gastro.2018.12.036
D’Onofrio M, Crosara S, De Robertis R, Canestrini S, Demozzi E, Gallotti A, et al. Acoustic radiation force impulse of the liver. World J Gastroenterol. 2013;19(30):4841-9. https://doi.org/10.3748/wjg.v19.i30.4841
Cassinotto C, Lapuyade B, Aït-Ali A, Vergniol J, Gaye D, Foucher J, et al. Liver fibrosis: noninvasive assessment with acoustic radiation force impulse elastography--comparison with FibroScan M and XL probes and FibroTest in patients with chronic liver disease. Radiology. 2013;269(1):283-92. https://doi.org/10.1148/radiol.13122208
Ferraioli G, Tinelli C, Dal Bello B, Zicchetti M, Filice G, Filice C; et al. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Hepatology. 2012;56(6):2125-33. https://doi.org/10.1002/hep.25936
Sharpton SR, Tamaki N, Bettencourt R, Madamba E, Jung J, Liu A, et al. Diagnostic accuracy of two-dimensional shear wave elastography and transient elastography in nonalcoholic fatty liver disease. Therap Adv Gastroenterol. 2021;14:17562848211050436. https://doi.org/10.1177/17562848211050436
Cassinotto C, Boursier J, Paisant A, Guiu B, Irles-Depe M, Canivet C, et al. Transient Versus Two-Dimensional Shear-Wave Elastography in a Multistep Strategy to Detect Advanced Fibrosis in NAFLD. Hepatology. 2021;73(6):2196-2205. https://doi.org/10.1002/hep.31655
Furlan A, Tublin ME, Yu L, Chopra KB, Lippello A, Behari J. Comparison of 2D Shear Wave Elastography, Transient Elastography, and MR Elastography for the Diagnosis of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. AJR Am J Roentgenol. 2020;214(1):W20-W26. https://doi.org/10.2214/AJR.19.21267
Singh S, Venkatesh SK, Wang Z, Miller FH, Motosugi U, Low RN, et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol. 2015;13(3):440-451.e6. https://doi.org/10.1016/j.cgh.2014.09.046
Yin M, Talwalkar JA, Glaser KJ, Manduca A, Grimm RC, Rossman PJ, et al. Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol. 2007;5(10):1207-1213.e2. https://doi.org/10.1016/j.cgh.2007.06.012
Imajo K, Kessoku T, Honda Y, Tomeno W, Ogawa Y, Mawatari H, et al. Magnetic Resonance Imaging More Accurately Classifies Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease Than Transient Elastography. Gastroenterology. 2016;150(3):626-637.e7. https://doi.org/10.1053/j.gastro.2015.11.048
Dietrich CG, Rau M, Geier A. Screening for nonalcoholic fatty liver disease-when, who and how? World J Gastroenterol. 2021;27(35):5803-5821. https://doi.org/10.3748/wjg.v27.i35.5803
Saiman Y, Duarte-Rojo A, Rinella ME. Fatty Liver Disease: Diagnosis and Stratification. Annu Rev Med. 2022;73:529-544. https://doi.org/10.1146/annurev-med-042220-020407
Sanyal AJ, Brunt EM, Kleiner DE, Kowdley KV, Chalasani N, Lavine JE, et al. Endpoints and clinical trial design for nonalcoholic steatohepatitis. Hepatology. 2011;54(1):344-53. https://doi.org/10.1002/hep.24376
Friedman SL, Neuschwander-Tetri BA, Rinella M, Sanyal AJ. Mechanisms of NAFLD development and therapeutic strategies. Nat Med. 2018;24(7):908-922. https://doi.org/10.1038/s41591-018-0104-9
Musso G, Cassader M, Rosina F, Gambino R. Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials. Diabetologia. 2012;55(4):885-904. https://doi.org/10.1007/s00125-011-2446-4
Beltrán O, Galindo A, Mendoza Y, Hernández G, Varón A, Garzón M, et al. Guía de práctica clínica para la enfermedad hepática grasa no alcohólica. Rev Col Gastroenterol. 2015;30(1):89-96.
Paternostro R, Trauner M. Current treatment of non-alcoholic fatty liver disease. J Intern Med. 2022;292(2):190-204. https://doi.org/10.1111/joim.13531
Haigh L, Kirk C, Gendy K, Gallacher J, Errington L, Mathers J, et al. The effectiveness and acceptability of Mediterranean diet and calorie restriction in non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis. Clin Nutr. 2022;41(9):1913-1931. https://doi.org/10.1016/j.clnu.2022.06.037
Zelber-Sagi S. Dietary Treatment for NAFLD: New Clinical and Epidemiological Evidence and Updated Recommendations. Semin Liver Dis. 2021;41(3):248-262. https://doi.org/10.1055/s-0041-1729971
Gepner Y, Shelef I, Komy O, Cohen N, Schwarzfuchs D, Bril N, et al. The benefcial efects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content. J Hepatol. 2019;71(2):379-88. https://doi.org/10.1016/j.jhep.2019.04.013
Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, Torres-Gonzalez A, Gra-Oramas B, Gonzalez-Fabian L, et al. Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis. Gastroenterology. 2015;149(2):367-78.e5. https://doi.org/10.1053/j.gastro.2015.04.005
Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010;51(1):121-9. https://doi.org/10.1002/hep.23276
Croci I, Coombes JS, Bucher Sandbakk S, Keating SE, Nauman J, Macdonald GA, et al. Non-alcoholic fatty liver disease: Prevalence and all-cause mortality according to sedentary behaviour and cardiorespiratory fitness. The HUNT Study. Prog Cardiovasc Dis. 2019;62(2):127-134. https://doi.org/10.1016/j.pcad.2019.01.005
Kim D, Murag S, Cholankeril G, Cheung A, Harrison SA, Younossi ZM, et al. Physical Activity, Measured Objectively, Is Associated With Lower Mortality in Patients With Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol. 2021;19(6):1240-1247.e5. https://doi.org/10.1016/j.cgh.2020.07.023
Musso G, Gambino R, Cassader M, Pagano G. A meta-analysis of randomized trials for the treatment of nonalcoholic fatty liver disease. Hepatology. 2010;52(1):79-104. https://doi.org/10.1002/hep.23623
Sanyal AJ, Chalasani N, Kowdley KV, McCullough A, Diehl AM, Bass NM, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med. 2010;362(18):1675-85. https://doi.org/10.1056/NEJMoa0907929
Hoofnagle JH, Van Natta ML, Kleiner DE, Clark JM, Kowdley KV, Loomba R, et al. Vitamin E and changes in serum alanine aminotransferase levels in patients with non-alcoholic steatohepatitis. Aliment Pharmacol Ther. 2013;38(2):134-43. https://doi.org/10.1111/apt.12352
Rakoski MO, Singal AG, Rogers MA, Conjeevaram H. Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis. Aliment Pharmacol Ther. 2010;32(10):1211-21. https://doi.org/10.1111/j.1365-2036.2010.04467.x
Kahl S, Pützer J, Roden M. Novel Antidiabetic Strategies and Diabetologists› Views in Nonalcoholic Steatohepatitis. Semin Liver Dis. 2022;42(1):48-60. https://doi.org/10.1055/s-0041-1732354
American Diabetes Association. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S111-S124. https://doi.org/10.2337/dc21-S009
Boettcher E, Csako G, Pucino F, Wesley R, Loomba R. Meta-analysis: pioglitazone improves liver histology and fibrosis in patients with non-alcoholic steatohepatitis. Aliment Pharmacol Ther. 2012;35(1):66-75. https://doi.org/10.1111/j.1365-2036.2011.04912.x
Lutchman G, Modi A, Kleiner DE, Promrat K, Heller T, Ghany M, et al. The effects of discontinuing pioglitazone in patients with nonalcoholic steatohepatitis. Hepatology. 2007;46(2):424-9. https://doi.org/10.1002/hep.21661
Cusi K, Orsak B, Bril F, Lomonaco R, Hecht J, Ortiz-Lopez C, et al. Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis and Prediabetes or Type 2 Diabetes Mellitus: A Randomized Trial. Ann Intern Med. 2016;165(5):305-15. https://doi.org/10.7326/M15-1774
Cusi K. Treatment of patients with type 2 diabetes and non-alcoholic fatty liver disease: current approaches and future directions. Diabetologia. 2016;59(6):1112-20. https://doi.org/10.1007/s00125-016-3952-1
Svegliati-Baroni G, Patrício B, Lioci G, Macedo MP, Gastaldelli A. Gut-pancreas-liver axis as a target for treatment of NAFLD/NASH. Int J Mol Sci 2020;21(16):5820. https://doi.org/10.3390/ijms21165820
Davies MJ, Aroda VR, Collins BS, Gabbay RA, Green J, Maruthur NM, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022;65(12):1925-1966. https://doi.org/10.1007/s00125-022-05787-2
Armstrong MJ, Gaunt P, Aithal GP, Barton D, Hull D, Parker R, et al. Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet. 2016;387(10019):679-690. https://doi.org/10.1016/S0140-6736(15)00803-X
Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015;373(1):11-22. https://doi.org/10.1056/NEJMoa1411892
Lingvay I, Desouza CV, Lalic KS, Rose L, Hansen T, Zacho J, et al. A 26-Week Randomized Controlled Trial of Semaglutide Once Daily Versus Liraglutide and Placebo in Patients With Type 2 Diabetes Suboptimally Controlled on Diet and Exercise With or Without Metformin. Diabetes Care. 2018;41(9):1926-1937. https://doi.org/10.2337/dc17-2381
Nachawi N, Rao PP, Makin V. The role of GLP-1 receptor agonists in managing type 2 diabetes. Cleve Clin J Med. 2022;89(8):457-464. https://doi.org/10.3949/ccjm.89a.21110
Androutsakos T, Nasiri-Ansari N, Bakasis AD, Kyrou I, Efstathopoulos E, Randeva HS, et al. SGLT-2 Inhibitors in NAFLD: Expanding Their Role beyond Diabetes and Cardioprotection. Int J Mol Sci. 2022;23(6):3107. https://doi.org/10.3390/ijms23063107
Lai LL, Vethakkan SR, Nik Mustapha NR, Mahadeva S, Chan WK. Empagliflozin for the Treatment of Nonalcoholic Steatohepatitis in Patients with Type 2 Diabetes Mellitus. Dig Dis Sci. 2020;65(2):623-631. https://doi.org/10.1007/s10620-019-5477-1
Abdallah M, Brown L, Provenza J, Tariq R, Gowda S, Singal AK. Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trials. Ann Hepatol. 2022 27(6):100738. https://doi.org/10.1016/j.aohep.2022.100738
Parker HM, Johnson NA, Burdon CA, Cohn JS, O’Connor HT, George J. Omega-3 supplementation and non-alcoholic fatty liver disease: a systematic review and meta-analysis. J Hepatol. 2012;56(4):944-51. https://doi.org/10.1016/j.jhep.2011.08.018
Hartman ML, Sanyal AJ, Loomba R, Wilson JM, Nikooienejad A, Bray R, et al. Effects of Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide on Biomarkers of Nonalcoholic Steatohepatitis in Patients With Type 2 Diabetes. Diabetes Care. 2020;43(6):1352-1355. https://doi.org/10.2337/dc19-1892
Chew NWS, Ng CH, Truong E, Noureddin M, Kowdley KV. Nonalcoholic Steatohepatitis Drug Development Pipeline: An Update. Semin Liver Dis. 2022;42(3):379-400. https://doi.org/10.1055/a-1877-9656
Hashem A, Khalouf A, Acosta A. Management of Obesity and Nonalcoholic Fatty Liver Disease: A Literature Review. Semin Liver Dis. 2021;41(4):435-447. https://doi.org/10.1055/s-0041-1731704
Ali MR, Moustarah F, Kim JJ; American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. American Society for Metabolic and Bariatric Surgery position statement on intragastric balloon therapy endorsed by the Society of American Gastrointestinal and Endoscopic Surgeons. Surg Obes Relat Dis. 2016;12(3):462-467. https://doi.org/10.1016/j.soard.2015.12.026
Jirapinyo P, McCarty TR, Dolan RD, Shah R, Thompson CC. Effect of Endoscopic Bariatric and Metabolic Therapies on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2022;20(3):511-524.e1. https://doi.org/10.1016/j.cgh.2021.03.017
Ren M, Zhou X, Zhang Y, Mo F, Yang J, Yu M, et al. Effects of Bariatric Endoscopy on Non-Alcoholic Fatty Liver Disease: A Comprehensive Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2022;13:931519. https://doi.org/10.3389/fendo.2022.931519
Lassailly G, Caiazzo R, Buob D, Pigeyre M, Verkindt H, Labreuche J, et al. Bariatric Surgery Reduces Features of Nonalcoholic Steatohepatitis in Morbidly Obese Patients. Gastroenterology. 2015;149(2):379-88. https://doi.org/10.1053/j.gastro.2015.04.014
Lee Y, Doumouras AG, Yu J, Brar K, Banfield L, Gmora S, et al. Complete Resolution of Nonalcoholic Fatty Liver Disease After Bariatric Surgery: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2019;17(6):1040-1060.e11. https://doi.org/10.1016/j.cgh.2018.10.017
Vangoitsenhoven R, Wilson RL, Cherla DV, Tu C, Kashyap SR, Cummings DE, et al. Presence of Liver Steatosis Is Associated With Greater Diabetes Remission After Gastric Bypass Surgery. Diabetes Care. 2021;44(2):321-325. https://doi.org/10.2337/dc20-0150
Moussa O, Ardissino M, Heaton T, Tang A, Khan O, Ziprin P, et al. Effect of bariatric surgery on long-term cardiovascular outcomes: a nationwide nested cohort study. Eur Heart J. 2020;41(28):2660-2667. https://doi.org/10.1093/eurheartj/ehaa069
Mendoza YP, Becchetti C, Watt KD, Berzigotti A. Risks and Rewards of Bariatric Surgery in Advanced Chronic Liver Diseases. Semin Liver Dis. 2021;41(4):448-460. https://doi.org/10.1055/s-0041-1731705
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