Effect of multifactorial treatment on non-alcoholic fatty liver disease in metabolic syndrome: a randomised study

@article{Athyros2006EffectOM,
  title={Effect of multifactorial treatment on non-alcoholic fatty liver disease in metabolic syndrome: a randomised study},
  author={Vasilios G. Athyros and Dimitri P. Mikhailidis and Triandafillos P Didangelos and Olga Giouleme and Evangelos N. Liberopoulos and Asterios Karagiannis and Anna I. Kakafika and Konstantinos Tziomalos and Andrew K. Burroughs and Moses S. Elisaf},
  journal={Current Medical Research and Opinion},
  year={2006},
  volume={22},
  pages={873 - 883}
}
ABSTRACT Background: Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome (MetS). There is no established treatment for NAFLD. Aim: To evaluate a multifactorial intervention in the treatment of NAFLD. Methods: A prospective, open-label, randomised study in non-diabetic patients (n = 186) with MetS (follow-up: 54 weeks). All patients had both biochemical and ultrasonographic evidence of NAFLD at baseline. Other causes of liver disease were excluded… 
Statins for non‐alcoholic fatty liver disease: a new indication?
TLDR
The benefit of atorvastatin in the study was seen ‘on the top’ of multifactorial treatment aimed at tackling all components of the metabolic syndrome and both biochemical and ultrasonographic evidence of NAFLD.
Safety and impact on cardiovascular events of long-term multifactorial treatment in patients with metabolic syndrome and abnormal liver function tests: a post hoc analysis of the randomised ATTEMPT study
TLDR
Lipid levels and LFTs normalized, US findings associated with NAFLD resolved and no CVD events occurred in patients with LDL-C levels<100 mg/dl (group A2).
Comment on: Novel therapeutic targets for non-alcoholic fatty liver disease
TLDR
Given that diet alone has no effect on liver fibrosis and the speed of liver pathology improvement, the authors suggest that these effects of statins are mostly of pleiotropic nature.
The Evaluation of Effective Drugs for the Treatment of Non-Alcoholic Fatty Liver Disease: A Systematic Review and Network Meta-Analysis
TLDR
A meta-analysis showed that atorvastatin, tryptophan, orlistat, omega-3 and obeticholic acid had a remarkable effect on NAFLD-patients by decreasing aminotransferases.
Combination drug treatment in patients with non-alcoholic fatty liver disease.
TLDR
This group has investigated the orlistat-fenofibrate-ezetimibe and sibutramine-antihypertensive combination treatment in obese patients with hyperlipidaemia with promising results in CVD risk factor reduction and improvement of liver function tests.
Therapy of nonalcoholic fatty liver disease: current status.
TLDR
Weight loss medication orlistat, ursodeoxycholic acid and antioxidant agents could potentially be used as adjunctive therapy and lifestyle modifications at present remain the only essential considerations in the NAFLD treatment.
Lipid-Lowering Agents in Nonalcoholic Fatty Liver Disease and Steatohepatitis: Human Studies
TLDR
The results of studies provide compelling evidence that lipid-lowering agents are safe and efficacious in patients with NAFLD/NASH and that some of these agents can induce a reduction in the extent of the hepatic steatosis.
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
TLDR
Weight loss is safe, and improves liver histology and cardio-metabolic profile, and for patients not responding to lifestyle intervention, pioglitazone improves histological disease activity, slows fibrosis progression and extensively ameliorates cardio- Metabolic endpoints.
Pharmacological treatment of non-alcoholic steatohepatitis: The current evidence
TLDR
This review focuses on studies using liver biopsies for the diagnosis of NASH as well as for the evaluation of treatment effects, and assesses the efficacy and safety of the pharmacological treatment ofNASH.
...
...

References

SHOWING 1-10 OF 59 REFERENCES
A Randomized Controlled Trial of Metformin versus Vitamin E or Prescriptive Diet in Nonalcoholic Fatty Liver Disease
TLDR
Limited histological data support an association between improved aminotransferases and biopsy findings, which require confirmation in a double-blind trial with appropriate statistical power based on liver histology.
Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome
TLDR
The presence of multiple metabolic disorders is associated with a potentially progressive, severe liver disease and the increasing prevalence of obesity, coupled with diabetes, dyslipidemia, hypertension, and ultimately the metabolic syndrome puts a very large population at risk of forthcoming liver failure in the next decades.
The ORlistat and CArdiovascular risk profile in patients with metabolic syndrome and type 2 DIAbetes (ORliCARDIA) study
TLDR
Orlistat plus HCD favourably modified several cardiovascular risk factors in patients with both MetSyn and type 2 DM, which might partly offset the excess cardiovascular risk and improve outcome in this patient population.
A pilot study of pioglitazone treatment for nonalcoholic steatohepatitis
TLDR
It is indicated that treatment with an insulin‐sensitizing agent can lead to improvement in biochemical and histological features of NASH and support the role of insulin resistance in the pathogenesis of this disease.
Nonalcoholic Fatty Liver Disease Is Associated With Carotid Atherosclerosis: A Case–Control Study
TLDR
Patients with NAFLD show a cluster of risk factors of the metabolic syndrome and advanced carotid atherosclerosis, and its detection on abdominal ultrasound should alert to the existence of an increased cardiovascular risk.
Nonalcoholic fatty liver disease and risk of future cardiovascular events among type 2 diabetic patients.
TLDR
In conclusion, NAFLD is significantly associated with a moderately increased CVD risk among type 2 diabetic individuals and is independent of classical risk factors and is only partly explained by occurrence of metabolic syndrome.
Efficacy of omega-3 fatty acids, atorvastatin and orlistat in non-alcoholic fatty liver disease with dyslipidemia.
TLDR
A decline in transaminase levels and normalization of ultrasonographic evidence of fatty liver were observed on treatment with omega-3 fatty acids in patients withhypertriglyceridemia, with atorvastatin in those with hypercholesterolemia, and orlistat in overweight patients with hyperlipidemia.
Increased prevalence of fatty liver in arterial hypertensive patients with normal liver enzymes: role of insulin resistance
TLDR
The higher prevalence of non-alcoholic fatty liver in non-obese hypertensive patients with normal liver enzymes appears to be related to increases in insulin resistance and body weight.
...
...