Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

Sumio Watanabe, Etsuko Hashimoto, Kenichi Ikejima, Hirofumi Uto, Masafumi Ono, Yoshio Sumida, Masataka Seike, Yoshiyuki Takei, Tetsuo Takehara, Katsutoshi Tokushige, Atsushi Nakajima, Masashi Yoneda, Toshiji Saibara, Goshi Shiota, Isao Sakaida, Makoto Nakamuta, Toshihiko Mizuta, Hirohito Tsubouchi, Kentaro Sugano, Tooru Shimosegawa

Research output: Contribution to journalReview articlepeer-review

119 Citations (Scopus)

Abstract

Nonalcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease in industrialized countries worldwide, and has become a serious public health issue not only in Western countries but also in many Asian countries including Japan. Within the wide spectrum of NAFLD, nonalcoholic steatohepatitis (NASH) is a progressive form of disease, which often develops into liver cirrhosis and increases the risk of hepatocellular carcinoma. In turn, a large proportion of NAFLD/NASH is the liver manifestation of metabolic syndrome, suggesting that NAFLD/NASH plays a key role in the pathogenesis of systemic atherosclerotic diseases. Currently, a definite diagnosis of NASH requires liver biopsy, though various noninvasive measures are under development. The mainstays of prevention and treatment of NAFLD/NASH include dietary restriction and exercise; however, pharmacological approaches are often necessary. Currently, vitamin E and thiazolidinedione derivatives are the most evidence-based therapeutic options, although the clinical evidence for long-term efficacy and safety is limited. This practice guideline for NAFLD/NASH, established by the Japanese Society of Gastroenterology in cooperation with The Japan Society of Hepatology, covers lines of clinical evidence reported internationally in the period starting from 1983 to January 2012, and each clinical question was evaluated using the GRADE system. Based on the primary release of the full version in Japanese, this English summary provides the core essentials of this clinical practice guideline comprising the definition, diagnosis, and current therapeutic recommendations for NAFLD/NASH in Japan.

Original languageEnglish
Pages (from-to)364-377
Number of pages14
JournalJournal of gastroenterology
Volume50
Issue number4
DOIs
Publication statusPublished - 2015 Apr 1

Keywords

  • NAFLD/NASH guideline
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis'. Together they form a unique fingerprint.

Cite this