Clin Mol Hepatol.  2016 Sep;22(3):327-335. 10.3350/cmh.2016.0049.

Non-alcoholic fatty liver diseases: update on the challenge of diagnosis and treatment

• Oh H
• Jun DW
• Saeed WK
• Nguyen MH

• KMID: 2373132
• DOI: http://doi.org/10.3350/cmh.2016.0049

Abstract

The prevalence of non-alcoholic fatty liver disease (NAFLD) is estimated to be 25-30% of the population, and is the most common cause of elevated liver enzymes in Korea. NAFLD is a "hot potato" for pharmaceutical companies. Many clinical trials are underway to develop a first-in-class drug to treat NAFLD. However, there are several challenging issues regarding the diagnosis of NAFLD. Currently, liver biopsy is the gold standard method for the diagnosis of NAFLD and steatohepatitis. Ideally, globally recognized standards for histological diagnosis and methods to optimize observer agreement on biopsy interpretation should be developed. Liver biopsy is the best method rather than a perfect one. Recently, multi-parametric magnetic resonance imagery can estimate the amount of intrahepatic fat successfully and is widely used in clinical trials. But no diagnostic method can discriminate between steatohepatitis and simple steatosis. The other unresolved issue in regard to NAFLD is the absence of satisfactory treatment options. Vitamin E and obeticholic acid have shown protective effects in randomized controlled trials, but this drug has not been approved for use in Korea. This study will provide a description of diagnostic methods and treatments that are currently recommended for NAFLD.

Keyword

Non-alcoholic fatty liver; Diagnosis; Treatment

MeSH Terms

Biomarkers/analysis
Chenodeoxycholic Acid/analogs & derivatives/therapeutic use
Clinical Trials as Topic
Fatty Liver/diagnosis
Fibrosis
Humans
Liver/diagnostic imaging/pathology
Magnetic Resonance Imaging
Non-alcoholic Fatty Liver Disease/*diagnosis/drug therapy
Tomography, X-Ray Computed
Ultrasonography
Vitamin E/therapeutic use
Biomarkers
Chenodeoxycholic Acid
Vitamin E