Clinical Gastroenterology Vol.28 No.4(8-3)

Theme NASH -- Pathogenesis and Treatment
Title Utility of Drugs for Dyslipidemia in the Treatment of NAFLD/NASH
Publish Date 2013/04
Author Kenichi Ikejima Department of Gastroenterology, Juntendo University Graduate School of Medicine
[ Summary ] Metabolic syndrome-related nonalcoholic fatty liver disease (NAFLD) is a growing health problem in industrialized countries worldwide with an escalation in numbers of cases of nonalcoholic steatohepatitis (NASH), a progressive form of NAFLD. The strategies for prevention and treatment of NAFLD/NASH are not currently available. Since dyslipidemia is one of the core characteristics of metabolic syndrome, various classes of lipid lowering drugs, including statins, cholesterol transporter inhibitors, fibrates, and omega-3 fatty acids, are used for the treatment of dyslipidemia in NAFLD/NASH patients. These drugs were designed for the prevention of atherosclerotic diseases ; however, the clinical evidence of these drugs on NAFLD/NASH is quite limited to date. Statins have been shown to be used safely in patients with chronic liver diseases including NAFLD/NASH without serious attenuation of liver injury. Fibrates may be beneficial in cases when NASH occurs in patients who suffer from drug-induced inhibition of β-oxidation. Omega-3 fatty acid treatment has been found to be beneficial for treatment of hypertriglyceridemia but the effect on liver disorders has not been evaluated thoroughly at this time. In conclusion, lipid lowering drugs are recommended only for the treatment of dyslipidemia and prevention of atherosclerotic diseases in patients with the primary, common form of NAFLD/NASH.
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