What is the treatment for hepatic steatosis?

From the Guidelines

Treatment of Hepatic Steatosis The treatment of hepatic steatosis, also known as non-alcoholic fatty liver disease (NAFLD), typically involves a multifaceted approach, including lifestyle modifications and pharmacological interventions 1.

Lifestyle Modifications

• Weight Loss: Weight loss through dietary changes and increased physical activity is recommended, aiming for a weight reduction of 7-10% of initial body weight over a period of 6-12 months 1.
• Dietary Changes: A Mediterranean diet, which is rich in fruits, vegetables, whole grains, and healthy fats, is recommended for patients with NAFLD 1.
• Physical Activity: Regular physical activity, such as aerobic exercise, is recommended to improve insulin sensitivity and reduce liver fat 1.

Pharmacological Interventions

• Vitamin E: Vitamin E may be prescribed at a dose of 800 IU daily for a duration of 2 years, particularly for patients with non-diabetic NAFLD 1.
• Pioglitazone: Pioglitazone may be prescribed at a dose of 30 mg daily for a duration of 12-18 months, particularly for patients with diabetic NAFLD 1.
• GLP-1 Receptor Agonists: GLP-1 receptor agonists, such as semaglutide, may be considered for patients with NAFLD and type 2 diabetes 1.
• Resmetirom: Resmetirom may be considered for patients with non-cirrhotic NAFLD and significant liver fibrosis 1.

Other Considerations

• Bariatric Surgery: Bariatric surgery may be considered for patients with NAFLD and obesity 1.
• Alcohol Consumption: Patients with NAFLD should be advised to avoid excessive alcohol consumption 1.
• Cardiovascular Risk Reduction: Patients with NAFLD should be managed for cardiovascular risk factors, such as hypertension and dyslipidemia, according to standard guidelines 1.

From the Research

Treatment Options for Hepatic Steatosis

The treatment for hepatic steatosis, also known as non-alcoholic fatty liver disease (NAFLD), involves lifestyle modifications and pharmacological interventions.

• Lifestyle modifications are considered the first-line therapy for NAFLD, with a focus on weight loss, diet, and physical activity 2, 3, 4, 5.
• A 7 to 10% reduction in weight can improve steatosis, inflammation, hepatocyte ballooning, and fibrosis 2.
• Combined exercise and diet interventions have been shown to be more effective than diet or exercise alone in improving liver enzymes and insulin resistance 2.
• Pharmacological interventions, such as Vitamin E and Pioglitazone, are also considered for the treatment of NAFLD, although their effectiveness is still being studied 3, 6.

Lifestyle Modifications

Lifestyle modifications play a crucial role in the management of NAFLD.

• Diet: A Mediterranean diet and other dietary interventions can help reduce liver fat and improve liver function 2, 4, 6.
• Exercise: Physical activity, including aerobic and resistance training, can reduce hepatic fat and improve insulin sensitivity, even in the absence of weight loss 2, 5.
• Weight loss: A reduction in weight can improve steatosis, inflammation, and fibrosis, and is considered the primary goal of lifestyle modifications for NAFLD 2, 4.

Pharmacological Interventions

Pharmacological interventions are also being studied for the treatment of NAFLD.

• Vitamin E and Pioglitazone are currently considered for the treatment of NAFLD, although their effectiveness is still being studied 3.
• Other pharmacological agents, such as GLP-1 agonists, FXR and PPAR ligands, are being investigated for their potential therapeutic effects on NAFLD 3, 6.