General practice Terapia 2020, 3 ( 386 ) : 82 - 92
Practical aspects of NAFLD treatment in the light of the latest Polish NAFLD Expert Group 2019 recommendations
Summary:
In 2016 the European Association for the Study of the Liver (EASL), the European Association for the Study of Diabetes (EASD) and the European Association for the Study of Obesity (EASO) developed and published Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease (NAFLD). In 2019, on the initiative of Professor Marek Hartleb representing the NAFLD Expert Group, a group of 20 Polish experts in gastroenterology, diabetes, cardiology, obesitology, family medicine, pharmacology, transplantology, dietetics, pediatrics and pathology developed recommendations of Polish experts in the management of patients with NAFLD. Clinicians, especially family doctors, annually receive numerous guidelines from expert groups on different disease entities, which are usually very detailed, which makes it difficult with limited time to become familiar with them and implement them into everyday clinical practice. Therefore the paper aims to outline the guidelines of the Polish group of experts in a nutshell, so that the practitioner can become familiar with their key elements and apply them in daily clinical practice.
The primary form of NAFLD is metabolic complication of obesity, and an important link of the pathogenesis of the other obesity metabolic complications (type 2 diabetes, lipid disturbances, atherosclerosis, cardiovascular diseases and endocrine disturbances). Therefore, diagnosis of NAFLD should be carried out in all patients with obesity, and a diagnosis of obesity and its metabolic complications should be carried out in all patients diagnosed with NAFLD. It should also be remembered that in patients with metabolic complications of obesity, the risk of developing non-alcoholic fatty hepatitis (NASH) increases significantly. If the right treatment is used, i.e. effective treatment of obesity and its possible metabolic complications, for example ursodeoxycholic acid (UDCA), hepatic histological reversal may be achieved until cirrhosis develops.
The primary form of NAFLD is metabolic complication of obesity, and an important link of the pathogenesis of the other obesity metabolic complications (type 2 diabetes, lipid disturbances, atherosclerosis, cardiovascular diseases and endocrine disturbances). Therefore, diagnosis of NAFLD should be carried out in all patients with obesity, and a diagnosis of obesity and its metabolic complications should be carried out in all patients diagnosed with NAFLD. It should also be remembered that in patients with metabolic complications of obesity, the risk of developing non-alcoholic fatty hepatitis (NASH) increases significantly. If the right treatment is used, i.e. effective treatment of obesity and its possible metabolic complications, for example ursodeoxycholic acid (UDCA), hepatic histological reversal may be achieved until cirrhosis develops.
Keywords: non-alcoholic fatty liver disease, treatment
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