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How should we manage patients with non-alcoholic fatty liver disease in 2007?

Show simple item record Chan, H.L. en_US de Silva, H.J. en_US Leung, N.W. en_US Lim, S.G. en_US Farrell, G.C. en_US 2014-10-29T09:25:30Z 2014-10-29T09:25:30Z 2007 en_US
dc.identifier.citation Journal of Gastroenterology and Hepatology. 2007; 22(6): pp.801-8 en_US
dc.identifier.issn 0815-9319 (Print) en_US
dc.identifier.issn 1440-1746 (Electronic) en_US
dc.description.abstract Evidence-based management guidelines for non-alcoholic fatty liver disease (NAFLD) are lacking in the Asia-Pacific region or elsewhere. This review reports the results of a systematic literature search and expert opinions. The Asia-Pacific Working Party on NAFLD (APWP-NAFLD) has generated practical recommendations on management of NAFLD in this region. NAFLD should be suspected when there are metabolic risk factors and/or characteristic changes on hepatic ultrasonography. Diagnosis by ultrasonography, assessment of liver function and complications, exclusion of otherliver diseases and screening for metabolic syndrome comprise initial assessment. Liver biopsy should be considered when there is diagnostic uncertainty, for patients at risk of advanced fibrosis, for those enrolled in clinical trials and at laparoscopy for another purpose. Lifestyle measures such as dietary restrictions and increased physical activity (aerobic exercise) should be encouraged, although the best management strategy to achieve this has yet to be defined. Complications of metabolic syndrome should be screened for regularly. Use of statins to treat hypercholesterolemia is safe and recommended; frequent alanine aminotransferase (ALT) monitoring is not required. Obese patients who do not respond to lifestyle measures should be referred to centers specializing in obesity management; consideration should be given to bariatric surgery or gastric ballooning. The role of pharmacotherapy remains investigational and is not recommended for routine clinical practice. Non-alcoholic fatty liverdisease should be recognized as part of the metabolic syndrome and managed in a multidisciplinary approach that addresses liver disease in the context of risk factors for diabetes and premature cardiovascular disease. Lifestyle changes are the first line and mainstay of management en_US
dc.publisher Wiley-Blackwell en_US
dc.subject Fatty Liver-diagnosis en_US
dc.subject Fatty Liver-epidemiology en_US
dc.subject Fatty Liver-therapy en_US
dc.subject Metabolic Syndrome X en_US
dc.subject Risk Factors en_US
dc.subject Obesity en_US
dc.subject Severity of Illness Index en_US
dc.title How should we manage patients with non-alcoholic fatty liver disease in 2007? en_US
dc.type Review en_US
dc.identifier.department Medicine en_US
dc.creator.corporateauthor Asian Pacific Association of Gastroenterology en_US
dc.creator.corporateauthor Asian Pacific Association for the Study of the Liver en_US
dc.description.note ,Asia-Pacific Working Party on NAFLD en_US

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