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Enfermedad del hígado graso no alcohólico, asociación con la enfermedad cardiovascular y tratamiento (II). Tratamiento de la enfermedad del hígado graso no alcohólico

Published on Jul 1, 2017in Clínica e Investigación en Arteriosclerosis
· DOI :10.1016/j.arteri.2016.06.002
Ángel Brea9
Estimated H-index: 9
,
Xavier Pintó41
Estimated H-index: 41
+ 7 AuthorsJuan Pedro-Botet30
Estimated H-index: 30
(Autonomous University of Barcelona)
Abstract
Resumen La enfermedad del higado graso no alcoholico (EHGNA) comprende una serie de lesiones hepaticas histologicamente similares a las inducidas por el alcohol en personas con un consumo del mismo muy escaso o nulo. La importancia de la EHGNA radica en su alta prevalencia en nuestras sociedades occidentales y, desde el punto de vista hepatico, en su progresiva evolucion desde esteatosis a esteatohepatitis, cirrosis y cancer de higado. Durante la ultima decada se ha observado que la EHGNA da lugar a un incremento del riesgo cardiovascular con aceleracion de la arteriosclerosis y de los episodios cardiovasculares, principal causa de su morbimortalidad. Esta revision actualizada a enero de 2016 consta de 2 partes. En esta segunda parte se revisaran el tratamiento de la EHGNA y su influencia sobre la enfermedad cardiovascular, asi como los farmacos empleados en el control de los factores de riesgo cardiovascular que muestran un efecto beneficioso sobre esta hepatopatia.
  • References (212)
  • Citations (7)
References212
Newest
#1Naga Chalasani (IU: Indiana University)H-Index: 75
#2Zobair M. YounossiH-Index: 84
Last. Arun J. Sanyal (VCU: Virginia Commonwealth University)H-Index: 102
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Abstract This guidance provides a data-supported approach to the diagnostic, therapeutic, and preventive aspects of NAFLD care. A "Guidance" document is different from a "Guideline." Guidelines are developed by a multidisciplinary panel of experts and rate the quality (level) of the evidence and the strength of each recommendation using the Grading of Recommendations, Assessment Development, and Evaluation (GRADE) system. A guidance document is developed by a panel of experts in the topic, and g...
687 CitationsSource
#1Ángel BreaH-Index: 9
#2Xavier PintóH-Index: 41
Last. Juan Pedro-Botet (Autonomous University of Barcelona)H-Index: 30
view all 10 authors...
Non-alcoholic fatty liver disease (NAFLD) comprises a series of histologically lesions similar to those induced by alcohol consumption in people with very little or no liver damage. The importance of NAFLD is its high prevalence in the Western world and, from the point of view of the liver, in its gradual progression from steatosis to steatohepatitis, cirrhosis, and liver cancer. During the last decade it has been observed that NAFLD leads to an increased cardiovascular risk with acceleration of...
3 CitationsSource
#1Lokpal Bhatia (University of Southampton)H-Index: 8
#2Eleonora Scorletti (University of Southampton)H-Index: 13
Last. Christopher D. Byrne (University of Southampton)H-Index: 54
view all 6 authors...
Abstract Background and aims n-3 polyunsaturated fatty acid (PUFA) treatment may decrease liver fat in non-alcoholic fatty liver disease (NAFLD), but uncertainty exists whether this treatment also decreases cardiovascular disease (CVD) risk in NAFLD. We tested whether 15–18 months n-3 PUFA [docosahexaenoic acid (DHA) and eicosapentaenoic acid] (Omacor/Lovaza, 4 g/day) vs placebo decreased carotid intima-media thickness (CIMT) progression, a surrogate marker of CVD risk. We also evaluated if impr...
28 CitationsSource
#1Matthew J. Armstrong (NIHR: National Institute for Health Research)H-Index: 24
#2Piers Gaunt (University of Birmingham)H-Index: 5
Last. Philip N. Newsome (NIHR: National Institute for Health Research)H-Index: 34
view all 16 authors...
Summary Background Glucagon-like peptide-1 (GLP-1) analogues reduce hepatic steatosis, concentrations of liver enzymes, and insulin resistance in murine models of fatty liver disease. These analogues are licensed for type 2 diabetes, but their efficacy in patients with non-alcoholic steatohepatitis is unknown. We assessed the safety and efficacy of the long-acting GLP-1 analogue, liraglutide, in patients with non-alcoholic steatohepatitis. Methods This multicentre, double-blinded, randomised, pl...
378 CitationsSource
#1Matthew J. Armstrong (University of Birmingham)H-Index: 24
#2D. Hull (University of Birmingham)H-Index: 10
Last. Jeremy W. Tomlinson (University of Oxford)H-Index: 46
view all 11 authors...
Background & Aims Insulin resistance and lipotoxicity are pathognomonic in non-alcoholic steatohepatitis (NASH). Glucagon-like peptide-1 (GLP-1) analogues are licensed for type 2 diabetes, but no prospective experimental data exists in NASH. This study determined the effect of a long-acting GLP-1 analogue, liraglutide, on organ-specific insulin sensitivity, hepatic lipid handling and adipose dysfunction in biopsy-proven NASH. Methods Fourteen patients were randomised to 1.8mg liraglutide or plac...
105 CitationsSource
#1Laura J Carbone (University of Melbourne)H-Index: 2
#2Peter W AngusH-Index: 49
Last. Neville D. Yeomans (University of Melbourne)H-Index: 34
view all 3 authors...
Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease in Western societies. Despite its significance, there are no well-proven pharmacological treatments. Two novel classes of potential pharmacotherapies are the glucagon-like peptide-1 receptor agonists (GLP-1 RA) and dipeptidyl peptidase-4 inhibitors (DPP-4I), collectively known as incretin-based therapies. These have several metabolic and anti-inflammatory actions that may be of benefit in NA...
39 CitationsSource
As the weight of managing non-alcoholic fatty liver disease (NAFLD) presses down upon the shoulders of our healthcare systems, there is an urgent need for effective and sustainable management strategies. Our understanding what causes and moderates NAFLD has grown considerably over the past two decades, but essentially comes down to two things; 1) energy balance [calories in and out]; and 2) a background of genetic susceptibility. As the latter is relatively fixed (excluding epigenetic effects of...
8 CitationsSource
#1Shelley E. Keating (UQ: University of Queensland)H-Index: 11
#2Jacob George (USYD: University of Sydney)H-Index: 86
Last. Nathan A. Johnson (USYD: University of Sydney)H-Index: 25
view all 3 authors...
As exercise is now an established therapy for the management of non-alcoholic fatty liver disease (NAFLD), recent investigations have sought to identify the optimal dose (type, intensity and amount) of exercise for hepatic benefit. Here, the authors discuss the following: the role of aerobic exercise for the modulation of hepatic steatosis; the limited evidence for the role of resistance training in reducing liver fat; the lack of evidence from clinical trials on the role of exercise in non-alco...
20 CitationsSource
#1Kareem SalhiyyahH-Index: 3
#2Rachel Forster (Edin.: University of Edinburgh)H-Index: 6
Last. Jonathan Michaels (University of Sheffield)H-Index: 29
view all 6 authors...
BACKGROUND: Intermittent claudication (IC) is a symptom of peripheral arterial disease (PAD) and is associated with high morbidity and mortality. Pentoxifylline, one of many drugs used to treat IC, acts by decreasing blood viscosity, improving erythrocyte flexibility and promoting microcirculatory flow and tissue oxygen concentration. Many studies have evaluated the efficacy of pentoxifylline in treating individuals with PAD, but results of these studies are variable. This is an update of a revi...
35 CitationsSource
#1Paola DongiovanniH-Index: 39
#2Salvatore Petta (University of Palermo)H-Index: 41
Last. Luca Valenti (University of Milan)H-Index: 48
view all 19 authors...
Background & Aims Excess hepatic free cholesterol contributes to the pathogenesis of non-alcoholic steatohepatitis, and statins reduce cholesterol synthesis. Aim of this study was to assess whether statin use is associated with histological liver damage related to steatohepatitis. Methods The relationship between statin use, genetic risk factors, and liver damage was assessed in a multi-center cohort of 1201 European individuals, who underwent liver biopsy for suspected non-alcoholic steatohepat...
119 CitationsSource
Cited By7
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Last. Anna GalickaH-Index: 7
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It was investigated, using a female rat model of low and moderate exposure of human to cadmium (Cd, 1 and 5 mg Cd/kg diet for 3–24 months), whether a polyphenol-rich 0.1% aqueous extract from Aronia melanocarpa L. berries (AE) may prevent Cd-induced lipid peroxidation and oxidative modifications of proteins and deoxyribonucleic acid (DNA) in the liver. For this purpose, markers of lipid peroxidation (lipid peroxides and 8-isoprostane) and oxidative injury of proteins (protein carbonyl groups and...
Source
Resumen La enfermedad por higado graso no alcoholico (EHGNA) afecta practicamente a un tercio de la poblacion mundial. Mexico es uno de los paises cuya poblacion reune varios factores de riesgo para esta enfermedad y su prevalencia podria superar el 50%; es por eso que el panorama a mediano plazo es muy pesimista si no se toman acciones inmediatas para contrarrestar lo que ya se considera un problema de salud nacional. De ahi el interes de la Asociacion Mexicana de Gastroenterologia y de la Asoc...
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#1Magdalena Mężyńska (UMB: Medical University of Białystok)H-Index: 3
#2Malgorzata M. Brzóska (UMB: Medical University of Białystok)H-Index: 27
: Recently, the growing attention of the scientific community has been focused on the threat to health created by environmental pollutants, including toxic metals such as cadmium (Cd), and on the need of finding effective ways to prevent and treat the unfavorable health effects of exposure to them. Particularly promising for Cd, and thus arousing the greatest interest, is the possibility of using various ingredients present in plants, including mainly polyphenolic compounds. As the liver is one ...
4 CitationsSource
Abstract Nonalcoholic fatty liver disease (NAFLD) affects nearly one third of the population worldwide. Mexico is one of the countries whose population has several risk factors for the disease and its prevalence could surpass 50%. If immediate action is not taken to counteract what is now considered a national health problem, the medium-term panorama will be very bleak. This serious situation prompted the Asociacion Mexicana de Gastroenterologia and the Asociacion Mexicana de Hepatologia to prod...
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Last. B Pilat-MarcinkiewiczH-Index: 5
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The study investigated, in a rat model of low-level and moderate environmental exposure to cadmium (Cd; 1 or 5 mg Cd/kg diet, respectively, for 3 to 24 months), whether the co-administration of 0.1% extract from Aronia melanocarpa L. berries (AE) may protect against oxidative stress in the liver and in this way mediate this organ status. The intoxication with Cd, dose- and duration-dependently, weakened the enzymatic antioxidative barrier, decreased the concentrations of reduced glutathione and ...
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#1Raquel Cueto-Galán (UMA: University of Málaga)H-Index: 2
#2Francisco Javier Barón (UMA: University of Málaga)H-Index: 4
Last. Julia Wärnberg (UMA: University of Málaga)H-Index: 41
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Abstract Objective To analyze the effect of an intervention with a Mediterranean diet supplemented with either extra virgin olive oil or nuts, on the fatty liver index (FLI), compared to a low-fat control diet. Methods Participants of the PREDIMED-Malaga trial, free from cardiovascular disease at baseline, but with a high risk to develop it, were included in this study. Anthropometric measurements were assessed and blood samples were taken to calculate participants’ FLI at study baseline and aft...
7 CitationsSource
#1Raquel Cueto-Galán (UMA: University of Málaga)H-Index: 2
#2Francisco Javier Barón (UMA: University of Málaga)H-Index: 4
Last. Julia Wärnberg (UMA: University of Málaga)H-Index: 41
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Resumen Objetivo Analizar el efecto sobre el Indice de Higado Graso (FLI, Fatty Liver Index ) de la intervencion con dieta mediterranea enriquecida con aceite de oliva virgen extra o frutos secos frente a un grupo control con una dieta baja en grasas. Metodologia Participantes del ensayo PREDIMED-Malaga, libres de enfermedad cardiovascular basalmente, pero con alto riesgo de desarrollarla. Al inicio, al ano y a los 3, 5 y 6 anos se les realizo mediciones antropometricas y toma de muestras de san...
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