| [ Summary ] |
The incidence of Nonalcoholic fatty liver disease (NAFLD) has been increasing markedly in many nations, including Japan, over the past decades. At present, according to Japanese annual health check reports, 10‒40 % of Japanese adults demonstrate evidence of NAFLD on ultrasonography. Moreover, NAFLD is associated with obesity, dyslipidemia, pituitary dysfunction, hypertension, sleep apnea, chronic kidney disease, and type 2 diabetes mellitus. In addition, NAFLD often causes cardiovascular disease and cerebral stroke. Progress to cirrhosis enhances the onset of HCC and hepatic insufficiency.
Nonalcoholic steatohepatitis (NASH) accounts for about 10 % of NAFLD. However, medication that has a marked effect on NASH has not yet been developed. The types of medication/therapy for NASH is divided into four groups, as follows :1) Type 1 therapy targets metabolic processes and includes many drugs, such as peroxisome proliferator‒activator receptor agonist, incretins, and fibroblast growth factor ;2) Type 2 therapy aims at reducing oxidative stress and inflammation and includes medicaments such as caspase inhibitors and phosphodiesterase inhibitors ;3) Type 3 therapy targets the gut by medication (e.g., intestinal lipase inhibitors) or fecal microbiota transplantation ;4) Type 4 therapy aims to reduce hepatic fibrosis and includes medicaments such as simtuzumab. |