Published online Apr 27, 2014. doi: 10.4254/wjh.v6.i4.188
Revised: January 22, 2014
Accepted: February 20, 2014
Published online: April 27, 2014
The prevalence of obesity and related conditions like non-alcoholic fatty liver disease (NAFLD) is increasing worldwide and therapeutic options are limited. Alternative treatment options are therefore intensively sought after. An interesting candidate is the natural polyphenol resveratrol (RSV) that activates adenosinmonophosphate-activated protein kinase (AMPK) and silent information regulation-2 homolog 1 (SIRT1). In addition, RSV has known anti-oxidant and anti-inflammatory effects. Here, we review the current evidence for RSV-mediated effects on NAFLD and address the different aspects of NAFLD and non-alcoholic steatohepatitis (NASH) pathogenesis with respect to free fatty acid (FFA) flux from adipose tissue, hepatic de novo lipogenesis, inadequate FFA β-oxidation and additional intra- and extrahepatic inflammatory and oxidant hits. We review the in vivo evidence from animal studies and clinical trials. The abundance of animal studies reports a decrease in hepatic triglyceride accumulation, liver weight and a general improvement in histological fatty liver changes, along with a reduction in circulating insulin, glucose and lipid levels. Some studies document AMPK or SIRT1 activation, and modulation of relevant markers of hepatic lipogenesis, inflammation and oxidation status. However, AMPK/SIRT1-independent actions are also likely. Clinical trials are scarce and have primarily been performed with a focus on overweight/obese participants without a focus on NAFLD/NASH and histological liver changes. Future clinical studies with appropriate design are needed to clarify the true impact of RSV treatment in NAFLD/NASH patients.
Core tip: The prevalence of obesity and related conditions like non-alcoholic fatty liver disease (NAFLD) is increasing. Therapeutic options are limited and alternative treatment options are sought after. An interesting candidate is resveratrol (RSV), a known AMP-activated protein kinase and silent information regulation-2 homolog 1 activator with anti-oxidant and anti-inflammatory properties. Here, we review the current evidence for RSV-mediated effects and address the different aspects of NAFLD and non-alcoholic steatohepatitis pathogenesis. We review the in vivo evidence from animal studies and clinical trials. Uniformly, animal studies report a decrease in hepatic triglyceride accumulation and improvements in histological fatty liver changes, whereas results from the few clinical trials are equivocal.