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Article 15, 4/2018


Nonalcoholic Fatty Liver Disease: Status Quo
Ioan Sporea1, Alina Popescu1, Dan Dumitrașcu2, Ciprian Brisc3, Laurențiu Nedelcu4, Anca Trifan5, Liana Gheorghe6, Carmen Fierbințeanu Braticevici7

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1) Department of Gastroenterology and Hepatology, Victor Babeș University of Medicine and Pharmacy, Timișoara
2) 2nd Department of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca
3) Department of Medical Disciplines, University of Oradea
4) Department of Internal Medicine, University Transilvania Brașov
5) Institute of Gastroenterology and Hepatology Iași, Grigore T. Popa University of Medicine and Pharmacy, Iași
6) Center for Gastroenterology and Hepatology, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest
7) Department of Gastroenterology, University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.274.quo

Nonalcoholic liver disease (NAFLD) is a hot topic for gastroenterologists and hepatologists and clinicalpractitioners must be kept abreast with the rapid progress of knowledge in this field. The Romanian Society of Gastroenterology and Hepatology (RSGH) has elaborated this review dedicated to evidence-based data on pathogenesis, diagnosis and therapy of this condition.
The term NAFLD includes two distinct conditions, with different histologic features and prognosis: nonalcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH), the second with the highest risk of evolution to cirrhosis and its complications, including hepatocellular carcinoma (HCC). Non-alcoholic fatty liver disease is considered the hepatic manifestation of the metabolic syndrome. Therefore, NAFLD is associated not only with an increase of liver-related mortality, but also of the overall mortality, especially cardiovascular and malignancies. Noninvasive techniques, such as biological tests and elastography can be used for the evaluation of NAFLD patients. Liver biopsy should be recommended in selected cases, for diagnostic, therapeutic and prognostic purposes. Patients with NAFLD would benefit from their lifestyle changes by progressive weight loss through
exercise and low fat and sugar diet. Pharmacotherapy should be reserved for patients with NASH, particularly for those with significant fibrosis. Until now, there are no FDA approved therapies for NASH.
Key words: fatty liver − metabolic syndrome − nonalcoholic fatty liver disease − nonalcoholic steatohepatitis.
Abbreviations: CAP: Controlled Attenuation Parameter; FFAs: free fatty acids; HCC: hepatocellular carcinoma; LB: liver biopsy; MRI: magnetic resonance imaging; MR-E: magnetic resonance imaging based elastography; NAFLD: Nonalcoholic fatty liver disease; NASH: Nonalcoholic steatohepatitis; PPAR: peroxisome proliferatoractivated receptor PUFA: n-3 polyunsaturated fatty acids; RSGH: Romanian Society of Gastroenterology and Hepatology; SWE: Shear Wave Elastography; T2DM: