Non-alcoholic fatty liver disease and insulin resistance

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NAFLD is a clinicopathological syndrome, which encloses a spectrum ranging from pure steatosis to steatohepatitis, fibrosis and cirrhosis with scarce steatosis.NAFLD occurs in 20% of the general population whereas NASH occurs in 3%.In NAFLD a self-perpetuating pathway between IR and inflammation may explain the necro-inflammation observed in the subset of patients with NASH, explaining why in patients with NAFLD, IR and the metabolic syndrome are associated with a higher risk of NASH and severe fibrosis.Secondary NAFLD may not be associated with IR and is probably sometimes disregarded.Insulin-sensitizing measures and drugs are promising in the treatment of NAFLD.Non-alcoholic fatty liver disease (NAFLD) is an entity now recognized as one of the leading causes of asymptomatic chronic elevation of aminotransferase levels, which can, however, progress to more advanced forms of hepatic lesion and ultimately to liver failure. Insulin resistance is considered as having a central role in NAFLD pathogenesis, which is related with oxidative stress, abnormal production of cytokines and deregulation of fatty acid metabolism. In this article the authors make a brief review of the epidemiological data about NAFLD and insulin resistance, and their aetiological link, and treatment implications.

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