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Published in Gastroenterology

Expert Opinion / My Approach · July 22, 2014

MY APPROACH to the Patient With NASH

Written by
Arthur J. McCullough MD
George Goh MD


Additional Info

  1. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55(6):200520-200523.
  2. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34(3):274-285.
  3. Pagadala M, Zein CO, McCullough AJ. Predictors of steatohepatitis and advanced fibrosis in non-alcoholic fatty liver disease. Clin Liver Dis. 2009;13(4):591-606.
  4. Promrat K, Kleiner DE, Niemeier HM, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010;51(1):121-129.
  5. Kistler KD, Brunt EM, Clark JM, et al. Physical activity recommendations, exercise intensity, and histological severity of nonalcoholic fatty liver disease. Am J Gastroenterol. 2011;106(3):460-468; quiz 9.
  6. Sofi F, Casini A. Mediterranean diet and non-alcoholic fatty liver disease: New therapeutic option around the corner? World J Gastroenterol. 2014;20(23):7339-7346.
  7. Abdelmalek MF, Suzuki A, Guy C, et al. Increased fructose consumption is associated with fibrosis severity in patients with nonalcoholic fatty liver disease. Hepatology. 2010;51(6):1961-1971.
  8. Chen S, Teoh NC, Chitturi S, Farrell GC. Coffee and non-alcoholic fatty liver disease: brewing evidence for hepatoprotection? J Gastroenterol Hepatol. 2014;29(3):435-441.
  9. Ruhl CE, Everhart JE. Coffee and caffeine consumption reduce the risk of elevated serum alanine aminotransferase activity in the United States. Gastroenterology. 2005;128(1):24-32.
  10. Goh GB, Chow WC, Wang R, Yuan JM, Koh WP. Coffee, alcohol and other beverages in relation to cirrhosis mortality: The Singapore Chinese Health Study [published online ahead of print February 6, 2014]. Hepatology. DOI: 10.1002/hep.27054.
  11. Dasarathy S, Dasarathy J, Khiyami A, et al. Double-blind randomized placebo-controlled clinical trial of omega 3 fatty acids for the treatment of diabetic patients with nonalcoholic steatohepatitis [published online ahead of print February 27, 2014]. J Clin Gastroenterol. doi: 10.1097/MCG.0000000000000099
  12. Sanyal AJ, Abdelmalek M, Suzuki A, Cummings W, Chojkier M; EPE-A Study Group. No significant effects of ethyl-eicosapentanoic acid on histologic features of nonalcoholic steatohepatitis in a phase 2 trial [published online ahead of print May 9, 2014]. Gastroenterology.
  13. Zein CO, Unalp A, Colvin R, Liu YC, McCullough AJ, Nonalcoholic Steatohepatitis Clinical Research Network. Smoking and severity of hepatic fibrosis in nonalcoholic fatty liver disease. J Hepatol. 2011;54(4):753-759.
  14. Mazzella N, Ricciardi LM, Mazzotti A, Marchesini G. The role of medications for the management of patients with NAFLD. Clin Liver Dis. 2014;18(1):73-89.
  15. Goh GB, Pagadala M, Dasarathy J, et al. Renin angiotensin system and fibrosis in non-alcoholic fatty liver disease [published online ahead of print June 6, 2014].Liv Int.
  16. Farrell G. Should we lower lipids in nonalcoholic fatty liver disease? Clin Gastroenterol Hepatol. 2014;12(1):152-155.
  17. Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. New Engl J Med. 2010;362(18):1675-1685.
  18. Zein CO, Yerian LM, Gogate P, et al. Pentoxifylline improves nonalcoholic steatohepatitis: a randomized placebo-controlled trial. Hepatology. 2011;54(5):1610-1619.
  19. Zeng T, Zhang CL, Zhao XL, Xie KQ. Pentoxifylline for the treatment of nonalcoholic fatty liver disease: a meta-analysis of randomized double-blind, placebo-controlled studies. Eur J Gastroenterol Hepatol. 2014;26(6):646-653.

Further Reading