This review summarizes our current understanding of nonalcoholic fatty liver disease (NAFLD), a multi-factorial systemic disease resulting from a complex interaction between a specific genetic background and multiple environmental/metabolic “hits”. The role of gut microbiota, lipotoxicity, inflammation and their molecular pathways is reviewed in-depth. We also discuss the epidemiology and natural history of NAFLD by pinpointing the remarkably high prevalence of NAFLD worldwide and its inherent systemic complications: hepatic (steatohepatitis, advanced fibrosis and cirrhosis), cardio-metabolic (cardiovascular disease, cardiomyopathy, arrhythmias and type 2 diabetes) and neoplastic (primary liver cancers and extra-hepatic cancers). Moreover, we critically report on the diagnostic role of non-invasive biomarkers, imaging techniques and liver biopsy, which remains the reference standard for diagnosing the disease, but cannot be proposed to all patients with suspected NAFLD. Finally, the management of NAFLD is also reviewed, by highlighting the lifestyle changes and the pharmacological options, with a focus on the innovative drugs. We conclude that the results of ongoing studies are eagerly expected to lead to introduce into the clinical arena new diagnostic and prognostic biomarkers, prevention and surveillance strategies as well as to new drugs for a tailored approach to the management of NAFLD in the individual patient.

AISF position paper on nonalcoholic fatty liver disease (NAFLD): Updates and future directions / Lonardo, Amedeo; Nascimbeni, Fabio; Targher, Giovanni; Bernardi, Mauro; Bonino, Ferruccio; Bugianesi, Elisabetta; Casini, Alessandro; Gastaldelli, Amalia; Marchesini, Giulio; Marra, Fabio; Miele, Luca; Morisco, Filomena; Petta, Salvatore; Piscaglia, Fabio; Svegliati-Baroni, Gianluca; Valenti, Luca; Bellentani, Stefano. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 49:5(2017), pp. 471-483. [10.1016/j.dld.2017.01.147]

AISF position paper on nonalcoholic fatty liver disease (NAFLD): Updates and future directions

Nascimbeni, Fabio;Bernardi, Mauro;Marchesini, Giulio;
2017

Abstract

This review summarizes our current understanding of nonalcoholic fatty liver disease (NAFLD), a multi-factorial systemic disease resulting from a complex interaction between a specific genetic background and multiple environmental/metabolic “hits”. The role of gut microbiota, lipotoxicity, inflammation and their molecular pathways is reviewed in-depth. We also discuss the epidemiology and natural history of NAFLD by pinpointing the remarkably high prevalence of NAFLD worldwide and its inherent systemic complications: hepatic (steatohepatitis, advanced fibrosis and cirrhosis), cardio-metabolic (cardiovascular disease, cardiomyopathy, arrhythmias and type 2 diabetes) and neoplastic (primary liver cancers and extra-hepatic cancers). Moreover, we critically report on the diagnostic role of non-invasive biomarkers, imaging techniques and liver biopsy, which remains the reference standard for diagnosing the disease, but cannot be proposed to all patients with suspected NAFLD. Finally, the management of NAFLD is also reviewed, by highlighting the lifestyle changes and the pharmacological options, with a focus on the innovative drugs. We conclude that the results of ongoing studies are eagerly expected to lead to introduce into the clinical arena new diagnostic and prognostic biomarkers, prevention and surveillance strategies as well as to new drugs for a tailored approach to the management of NAFLD in the individual patient.
49
5
471
483
AISF position paper on nonalcoholic fatty liver disease (NAFLD): Updates and future directions / Lonardo, Amedeo; Nascimbeni, Fabio; Targher, Giovanni; Bernardi, Mauro; Bonino, Ferruccio; Bugianesi, Elisabetta; Casini, Alessandro; Gastaldelli, Amalia; Marchesini, Giulio; Marra, Fabio; Miele, Luca; Morisco, Filomena; Petta, Salvatore; Piscaglia, Fabio; Svegliati-Baroni, Gianluca; Valenti, Luca; Bellentani, Stefano. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 49:5(2017), pp. 471-483. [10.1016/j.dld.2017.01.147]
Lonardo, Amedeo; Nascimbeni, Fabio; Targher, Giovanni; Bernardi, Mauro; Bonino, Ferruccio; Bugianesi, Elisabetta; Casini, Alessandro; Gastaldelli, Amalia; Marchesini, Giulio; Marra, Fabio; Miele, Luca; Morisco, Filomena; Petta, Salvatore; Piscaglia, Fabio; Svegliati-Baroni, Gianluca; Valenti, Luca; Bellentani, Stefano
File in questo prodotto:
File Dimensione Formato  
AISF Dig Liver Dis 2017.pdf

non disponibili

Tipologia: Versione dell'editore (versione pubblicata)
Dimensione 2.29 MB
Formato Adobe PDF
2.29 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1179560
Citazioni
  • ???jsp.display-item.citation.pmc??? 98
  • Scopus 204
  • ???jsp.display-item.citation.isi??? 164
social impact