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Non-alcoholic Fatty Liver Disease:A Clinical Update

Journal of Clinical and Translational Hepatology 2017年第4期5卷 384-393页

作者： Joseph M Pappachan shithu babu babu Krishnan Nishal C Ravindran Department of Endocrinology Diabetes&MetabolismRoyal Lancaster InfirmaryUniversity Hospitals of Morecambe Bay NHS TrustLancasterUK Department of Medicine Dorset County HospitalDorchesterUK Department of Gastroenterology&Hepatology Royal Bournemouth HospitalBournemouthUK Department of Gastroenterology&Hepatology Hinchingbrooke HospitalHinchingbrookeHuntingdonUK

Non-alcoholic fatty liver disease(NAFLD)is currently the most common chronic liver disease in developed countries because of the obesity *** disease increases liverrelated morbidity and mortality,and often increases the risk for other comorbidities,such as type 2 diabetes and cardiovascular *** resistance related to metabolic syndrome is the main pathogenic trigger that,in association with adverse genetic,humoral,hormonal and lifestyle factors,precipitates development of *** markers and radiological imaging,along with liver biopsy in selected cases,help in diagnosis and *** lifestyle changes aiming at weight loss are the main therapeutic intervention to manage *** sensitizers,antioxidants,lipid lowering agents,incretin-based drugs,weight loss medications,bariatric surgery and liver transplantation may be necessary for management in some cases along with lifestyle *** review summarizes the latest evidence on the epidemiology,natural history,pathogenesis,diagnosis and management of NAFLD.

关键词： Nonalcoholic fatty liver disease(NAFLD) Nonalcoholic steatohepatitis NASH Insulin resistance Metabolic syndrome Lifestyle interventions Bariatric surgery

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Gastrointestinal complications of diabetes mellitus

引用

World Journal of Diabetes 2013年第3期4卷 51-63页

作者： babu Krishnan shithu babu Jessica Walker Adrian B Walker Joseph M Pappachan Department of Gastroenterology University College HospitalLondon NW1 2BUUnited Kingdom Department of Medicine Watford General HospitalLondon WD18 0HBUnited Kingdom University of Newcastle Newcastle upon Tyne NE1 7RUUnited Kingdom Department of Endocrinology University Hospital of North Staffordshire NHS TrustStoke-on-Trent ST4 6QGUnited Kingdom

Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease,and other ***(GI) involvement can present with esophageal dysmotility,gastro-esophageal reflux disease(GERD),gastroparesis,enteropathy,non alcoholic fatty liver disease(NAFLD) and glycogenic *** of GERD is inversely related to glycemic control and management is with prokinetics and proton pump *** gastroparesis manifests as early satiety,bloating,vomiting,abdominal pain and erratic glycemic *** emptying scintigraphy is considered the gold standard test for *** includes dietary modifications,maintaining euglycemia,prokinetics,endoscopic and surgical *** enteropathy is also common and management involves glycemic control and symptomatic *** is considered a hepatic manifestation of metabolic syndrome and treatment ismainly lifestyle measures,with diabetes and dyslipidemia management when *** hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin *** GI complications of diabetes are relatively common,awareness about its manifestations and treatment options are low among *** management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the *** review is an update on the GI complications of diabetes,their pathophysiology,diagnostic evaluation and management.

关键词： Gastrointestinal complications Diabetes mellitus Esophageal complications Nonalcoholic fatty liver disease Diabetic gastroparesis Diabetic enteropathy Glycogenic hepatopathy

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