Changing Paradigm of Fatty Liver Management
DOI:
https://doi.org/10.17140/phoj.11.01.348Keywords:
Metabolic dysfunction-associated fatty liver disease, metabolic dysfunction-associated steatohepatitis, lifestyle modificationAbstract
Metabolically-dysfunction-associated fatty liver disease is a major health concern globally and is on the rise worldwide. It is a form of chronic liver disease with potentials of progression to liver cirrhosis and hepatocellular carcinoma. For long, lifestyle modification remained the only effective intervention for the management of this disease. However, the scenario is now gradually changing. Not only newer drugs are showing promise in the management of metabolic dysfunction-associated fatty liver disease, but some have also already been approved by different regulatory bodies. These include semaglutide, resmetirom and saroglitazar. Therefore, a shift in the of paradigm of management of patients presenting to us with metabolic dysfunction-associated fatty liver disease, metabolic dysfunction-associated steatohepatitis and complications is also gradually becoming visible.
References
Noor-E-Alam SM, Moben AL, Begum R, Rahim MA, Rahman MA, Saha M, Mahtab M, Khan S, Ak-bar SMF, Mahtab MA (2025) Dual drug therapy for fatty liver: A prospective real-life study from Bangladesh. Int J Med Pharm Res 6:253–258. ht tps://doi.org/10.5281/zenodo.17589078
Asrani S, Devarbhavi H, Eaton J, et al (2019) Bur-den of liver diseases in the world. J Hepatol 70:151–171. https://pubmed.ncbi.nlm.ni h.gov/30266282/
Rahman MM, Kibria MG, Begum H, Haque M, Sul-tana N, Akhter M, Rowshon AHM, Ahmed F, Hasan M (2020) NAFLD in rural South Asia. BMJ Open Gastroenterol 7:e000535. https://doi.org/10 .1136/bmjgast-2020-000535
Williamson R, Price J, Glancy S (2011) Hepatic steatosis in T2DM. Diabetes Care 34:1139–1144.
Hazlehurst JM, Woods C, Marjot T, Cobbold JF, Tomlinson JW (2016) NAFLD and diabetes. Metabolism 65:1096–1108.
EASL, EASD, EASO (2016) Clinical practice guide-lines for NAFLD. J Hepatol 64:1388–1402.
Hannah WN Jr, Harrison SA (2016) Weight loss and NAFLD. Clin Liver Dis 20:339–350.
Roy PP, Mahtab MA, Rahim MA, Yesmin SS, Islam SB, Akbar SMF (2022) Obeticholic acid in NASH. Euroasian J Hepatogastroenterol 12:S46–S50.
Bellentani S, Dalle Grave R, Suppini A, Marchesini G (2008) Behavioral therapy in NAFLD. Hepatol-ogy 47:746–754.
Musso G, Gambino R, Cassader M, Pagano G (2010) Meta-analysis of NAFLD treatments. Hep-atology 52:79–104.
Pawlak M, Lefebvre P, Staels B (2015) PPAR and lipid metabolism. J Hepatol 62:720–733.
Foucher J, Chanteloup E, Vergniol J, et al (2006) FibroScan diagnosis of cirrhosis. Gut 55:403–408.
Monteiro CA, Cannon G, Moubarac JC, et al (2018) Ultra-processed foods and nutrition. Pub-lic Health Nutr 21:5–17.
Adams J, White M (2015) UK diet and food pro-cessing. Int J Behav Nutr Phys Act 12:160.
Singh AK, Gandotra A, Kumar S, Singh A, Kochhar R, Manrai M (2025) Ultra-processed foods and gut health. World J Gastroenterol 31:109143.
Martini D, Godos J, Bonaccio M, Vitaglione P, Grosso G (2021) Ultra-processed foods meta-analysis. Nutrients 13:3390.
Pagliai G, Dinu M, Madarena MP, Bonaccio M, Ia-coviello L, Sofi F (2021) UPF consumption and health. Br J Nutr 125:308–318.
Gehring J, Touvier M, Baudry J, et al (2021) UPF consumption patterns. J Nutr 151:120–131.
Henney AE, Gillespie CS, Alam U, Hydes TJ, Cuth-bertson DJ (2023) UPF and NAFLD meta-analysis. Nutrients 15:2266.
Grinshpan LS, Eilat-Adar S, Ivancovsky-Wajcman D, et al (2023) UPF and metabolic risk. JHEP Rep 6:100964.
Zhang YF, Qiao W, Zhuang J, et al (2024) UPF and NAFLD UK Biobank. J Nutr Health Aging 28:100352.
Konieczna J, Morey M, Abete I, et al (2021) UPF and adiposity. Clin Nutr 40:4290–4300.
Szabo Z, Marosvölgyi T, Szabo E, et al (2022) Heat-ing oils and fatty acids. Foods 11:192.
UN-Habitat (2020) Public space indicator training module. https://unhabitat.org
United Nations (2020) Urbanization data. https: //www.un.org
Rahman SH, Islam M (2022) Urban green space in Dhaka. Bangladesh J Environ Res 13:1–12.
Estes C, Razavi H, Loomba R, Younossi Z, Sanyal AJ (2018) NAFLD burden modeling. Hepatology 67:123–133.
Marchesini G, Bugianesi E, Forlani G, et al (2003) NAFLD and metabolic syndrome. Hepatology 37:917–923.
FDA (2024) First treatment for liver fibrosis due to fatty liver. https://www.fda.gov
Harrison SA, Bedossa P, Guy CD, et al (2024) Resmetirom phase 3 trial. N Engl J Med 390:497– 509.
Harrison SA, Bashir M, Moussa SE, et al (2021) Resmetirom phase 2 study. Hepatol Commun 5:573–588.
Bansal MB, Patton H, Morgan TR, et al (2025) Semaglutide therapy update. Hepatology.
Jaiswal A, Jain K, Singh AK (2021) Saroglitazar in NAFLD. J Clin Diagn Res. https://doi.org/10 .7860/JCDR/2021/52065/15738
Jain MR, Giri SR, Bhoi B, et al (2018) Saroglitazar experimental study. Liver Int 38:1084–1094.
Sosale A, Saboo B, Sosale B (2015) Saroglitazar in T2DM. Diabetes Metab Syndr Obes 8:189–196.
Goyal O, Nohria S, Goyal P, et al (2020) Sarogli-tazar real-world study. Sci Rep 10:21117.
Gawrieh S, Noureddin M, Loo N, et al (2021) Saroglitazar RCT. Hepatology 74:1809–1824.
Moben AL, Begum R, Noor E Alam SM, et al (2025) Generic Saroglitazar study. UKR J Med Med Res. https://doi.org/10.5281/zenodo.1804701
Neuschwander-Tetri BA, Loomba R, Sanyal AJ, et al (2015) FLINT trial. Lancet 385:956–965.
Younossi ZM, Ratziu V, Loomba R, et al (2019) Obeticholic acid phase 3 trial. Lancet 394:2184– 2196.
Begum R, Moben AL, Noor E Alam SM, et al (2025) Generic Obeticholic acid study. J Med Med Res. https://zenodo.org/records/17962328
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