Topic Highlight
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Nov 27, 2014; 6(11): 800-811
Published online Nov 27, 2014. doi: 10.4254/wjh.v6.i11.800
Pathogenesis and therapeutic approaches for non-alcoholic fatty liver disease
Hye-jin Yoon, Bong Soo Cha
Hye-jin Yoon, Bong Soo Cha, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, South Korea
Author contributions: Yoon HJ and Cha BS equally contributed to this paper.
Correspondence to: Bong Soo Cha, MD, PhD, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemoon-gu, Seoul 120-752, South Korea. bscha@yuhs.ac
Telephone: +82-2-22281962 Fax: +82-2-3936884
Received: July 23, 2014
Revised: August 27, 2014
Accepted: October 14, 2014
Published online: November 27, 2014
Processing time: 120 Days and 6.8 Hours
Abstract

Non-alcoholic fatty liver disease affects approximately one-third of the population worldwide, and its incidence continues to increase with the increasing prevalence of other metabolic disorders such as type 2 diabetes. As non-alcoholic fatty liver disease can progress to liver cirrhosis, its treatment is attracting greater attention. The pathogenesis of non-alcoholic fatty liver disease is closely associated with insulin resistance and dyslipidemia, especially hypertriglyceridemia. Increased serum levels of free fatty acid and glucose can cause oxidative stress in the liver and peripheral tissue, leading to ectopic fat accumulation, especially in the liver. In this review, we summarize the mechanism underlying the progression of hepatic steatosis to steatohepatitis and cirrhosis. We also discuss established drugs that are already being used to treat non-alcoholic fatty liver disease, in addition to newly discovered agents, with respect to their mechanisms of drug action, focusing mainly on hepatic insulin resistance. As well, we review clinical data that demonstrate the efficacy of these drugs, together with improvements in biochemical or histological parameters.

Keywords: Non-alcoholic fatty liver disease; Insulin resistance; Drugs; Pathogenesis

Core tip: In this review, we summarize the pathogenesis underlying the progression of hepatic steatosis to steatohepatitis and cirrhosis. We also discuss established drugs that are already being used to treat non-alcoholic fatty liver disease, in addition to newly discovered agents, with respect to their mechanisms of drug action, focusing mainly on hepatic insulin resistance. As well, we review clinical data that demonstrate the efficacy of these drugs, together with improvements in biochemical or histological parameters. Furthermore, we introduced future treatment option for non-alcoholic fatty liver disease.