Pilihan Tatalaksana Penyakit Perlemakan Hati Non-Alkohol (Non-Alcoholic Fatty Liver Disease/ NAFLD)
DOI:
https://doi.org/10.55175/cdk.v48i3.54Keywords:
NAFLD, perlemakan hati non-alkohol, tatalaksanaAbstract
Penyakit perlemakan hati non-alkohol (non-alcoholic fatty liver disease/ NAFLD) merupakan kondisi adanya steatosis hepatik, inflamasi, dan kerusakan hepatosit (ballooning degeneration). NAFLD tidak hanya dianggap penyakit hati primer, tetapi juga merupakan bagian dari sindrom metabolik atau kondisi resistensi insulin dan penyakit terkait gaya hidup seperti diabetes, dislipidemia, dan hipertensi. Strategi tatalaksana NAFLD dimulai dari modifikasi gaya hidup, dapat dilanjutkan dengan terapi komponen sindrom metabolik, farmakoterapi, hingga penatalaksanaan sirosis.
Non-alcoholic fatty liver disease refers to a steatosis in liver, associated with inflammation and destruction of hepatocyte (ballooning degeneration). NAFLD is considered as primary liver disease, but also as a component of metabolic syndrome related to insulin resistance and other life-style-related diseases i.e diabetes mellitus, dyslipidemia, and hypertension. Strategies in NAFLD management start with lifestyle modification, continued with pharmacological approaches targeting metabolic syndrome and complications related to cirrhosis.
Downloads
References
Hashimoto E, Tokushige K, Ludwig J. Diagnosis and classification of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: Current concepts and remaining challenges. Hepatol Res. 2015;45(1):20-8.
Amarapurkar DN, Hashimoto E, Lesmana LA, Sollano JD, Chen PJ, Goh KL. How common is non-alcoholic fatty liver disease in the Asia–Pacific region and are there local differences? J Gastroenterol Hepatol. 2007;22(6):788–93.
Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metab Clin Exper. 2016;65(8):1038–48.
Dyson JK, Anstee QM, McPherson S. Non-alcoholic fatty liver disease: A practical approach to treatment. Frontline Gastroenterology. 2014;5:277–86.
Corey KE, Rinella ME. Medical and surgical treatment options for nonalcoholic steatohepatitis. Dig Dis Sci. 2016;61(5):1387–97.
Rubino F, Nathan DM, Eckel RH, Schauer PR, Alberti KG, Zimmet PZ, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: A joint statement by International Diabetes Organization. Diabetes Care. 2016;39(6):861–77.
Lassailly G, Caiazzo R, Buob D, Pigeyre M, Verkindt H, Labreuche J, et al. Bariatric surgery reduces features of nonalcoholic steatohepatitis in morbidly obese patients.Gastroenterology 2015;149(2):379–88.
Chavez-Tapia NC, Teller-Avila FI, Barrientos-Gutierrez T, Mendez-Sanchez N, Lizardi-Carvera J, Uribe M. Bariatric surgery for non-alcoholic steatohepatitis in obese patients. Cochrane Database of Systematic Reviews. 2010;1:CD006340.
European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. Obes Facts. 2016;9(2):65–90.
Lee YM, Low HC, Lim LG, Dan YY, Aung MO, Cheng CL, et al. Intragastric balloon significantly improves nonalcoholic fatty liver disease activity score in obese patients with nonalcoholic steatohepatitis: A pilot study. Gastrointest Endosc. 2012;76(4):756-60.
Chitturi S, Wong VW, Chan WK, Wong GL, Wong SK, Sollano J, et al. The Asia-Pacific working party on nonalcoholic fatty liver disease guidelines 2017 part 2: Management and special groups. J Gastroenterol Hepatol. 2018;33(1):86-98.
Sumida Y, Naito Y, Tanaka S, Sakai K, Inada Y, Taketani H, et al. Long-term (≥ 2 year) efficacy of vitamin E for non-alcoholic steatohepatitis. Hepatogastroenterology 2013;60(126):1445–50.
Defour JF, Oneta CM, Gonvers JJ, Bihl F, Cerny A, Cerada JM, et al. Randomized placebo-controlled trial of ursodeoxycholic acid with vitamin e in nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2006;4(12):1537-43.
Jiang C, Xie C, Li F, Zhang L, Nichols RG, Krausz KW, et al. Intestinal farnesoid X receptor signaling promotes nonalcoholic fatty liver disease. J Clin Invest. 2015;125(1):386–402.
Boursier J, Mueller O, Barret M, Machado M, Fizanne L, Araujo-Perez F, et al. The severity of non-alcoholic fatty liver disease is associated with gut dysbiosis and shift in the metabolic function of the gut microbiota. Hepatology (Baltimore, MD). 2016;63(3):764–75.
Loman BR, Hernandez-Saavedra D, An R, Rector RS. Prebiotic and probiotic treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis. Nutr Rev. 2018;76(11):822-39.
Ma J, Zhou Q, Li H. Gut microbiota and nonalcoholic fatty liver disease: Insights on mechanisms and therapy. Nutrients 2017;9(10):1124.
Eslamparast T, Poustchi H, Zamani F, Sharafkhah M, Malekzadeh R, Hekmatdoost A. Synbiotic supplementation in nonalcoholic fatty liver disease: A randomized, double-blind, placebo-controlled pilot study. Am J Clin Nutr. 2014;99(3):535–42.
Malaguarnera M, Vacante M, Antic T, Giordano M, Chisari G, Acquaviva R, et al. Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis. Dig Dis Sci. 2012;57(2):545–53.
Mofidi F, Poustchi H, Yari Z, Nourinayyer B, Merat S, Sharafkhah M, et al. Synbiotic supplementation in lean patients with non-alcoholic fatty liver disease: A pilot, randomised, double-blind, placebo-controlled, clinical trial. Br J Nutr. 2017;117(5):662–8.
Asgharian A, Askari G, Esmailzade A, Feizi A, Mohammadi V. The effect of symbiotic supplementation on liver enzymes, C-reactive protein and ultrasound findings in patients with non-alcoholic fatty liver disease: A clinical trial. Int J Prev Med. 2016;7(2016):59.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Cermin Dunia Kedokteran
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
