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Evidence‐based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis
Author(s) -
Watanabe Sumio,
Hashimoto Etsuko,
Ikejima Kenichi,
Uto Hirofumi,
Ono Masafumi,
Sumida Yoshio,
Seike Masataka,
Takei Yoshiyuki,
Takehara Tetsuo,
Tokushige Katsutoshi,
Nakajima Atsushi,
Yoneda Masashi,
Saibara Toshiji,
Shiota Goshi,
Sakaida Isao,
Nakamuta Makoto,
Mizuta Toshihiko,
Tsubouchi Hirohito,
Sugano Kentaro,
Shimosegawa Tooru
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12511
Subject(s) - medicine , hepatology , nonalcoholic fatty liver disease , cirrhosis , steatohepatitis , guideline , metabolic syndrome , fatty liver , liver biopsy , chronic liver disease , liver disease , gastroenterology , intensive care medicine , disease , pathology , biopsy , obesity
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, non‐alcoholic 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 non‐invasive 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 through 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.