Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2DM) are common conditions that regularly co-exist and can act synergistically to drive adverse outcomes. [4][11][13], No medicines specifically for NAFLD or NASH had received approval, as of 2018[update], although anti-diabetic medications may help in liver fat loss. [4], Bariatric surgery is an effective method for obese and diabetic individuals with NAFLD to induce weight loss and reduce or resolve NASH inflammation, including fibrosis, and improve longevity. As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells.NAFLD is increasingly common around the world, especially in Western nations. [4][13] The NICE advises the use of vitamin E for children with advanced liver fibrosis, whether they have diabetes or not. [14] The three sources of free fatty acids that contribute to liver triglyceride accumulation include FFAs circulating in the bloodstream (59%), FFAs derived from carbohydrates such as fructose and glucose (26%), and diet (14%). Adlay seed (Coix lacryma-jobi L.) extracts exhibit a prophylactic effect on diet-induced metabolic dysfunction and nonalcoholic fatty liver disease in mice. Typically, adipose tissue stores lipids in the form of triglycerides, slowly releasing them into the bloodstream when insulin is low. These changes appear to increase the permeability of intestinal tissue, thereby facilitating increased liver exposure to harmful substances (e.g., translocated bacteria, bacterial toxins, and inflammatory chemical signals). [13], Alcohol is an aggravating factor, and the AASLD recommends that people with NAFLD or NASH avoid alcohol consumption. [4][8][21][126] Since NAFLD is a complex disease that involves several organs and tissues, combination therapies (combining compounds) and conjugate therapies (combining drugs and non-pharmacological therapies such as behavioral therapies or lifestyle changes) are investigated as a way to increase the efficiency of medical treatment. [46], According to AASLD guidelines, a liver biopsy may be considered in people with NAFLD who are at increased risk of having steatohepatitis with or without advanced fibrosis, but only when all other competing chronic liver diseases are excluded (such as alcoholic liver disease). It is also associated with hormonal disorders (panhypopituitarism, hypothyroidism, hypogonadism, polycystic ovary syndrome), persistently elevated transaminases, increasing age and hypoxia caused by obstructive sleep apnea, with some of these conditions predicting disease progression. [110], EASL recommends Europe's public health authorities to "restrict advertising and marketing of sugar-sweetened beverages and industrially processed foods high in saturated fat, sugar, and salt", as well as "fiscal measures to discourage the consumption of sugar-sweetened beverages and legislation to ensure that the food industry improves labeling and the composition of processed foods", as well as "public awareness campaigns on liver disease, highlighting that it is not only linked to excessive consumption of alcohol". [5] Hispanic persons have a higher prevalence of NAFLD than white individuals, whereas the lowest prevalence is observed in black individuals. [18] Guidelines are available from the American Association for the Study of Liver Diseases (AASLD), American Association of Clinical Endocrinologists (AACE) National Institute for Health and Care Excellence (NICE), the European Association for the Study of the Liver (EASL), and the Asia-Pacific Working Party on NAFLD. [22] NASH can severely impair liver function, leading to cirrhosis, liver failure, and liver cancer. [4][8][11][61] The EASL allows alcohol consumption below 30g/day for men and 20g/day for women. Therefore, some researchers argue that non-alcoholic and alcoholic fatty liver diseases are more alike than previously thought. [1], People with NAFLD often have no noticeable symptoms, and NAFLD is often only detected during routine blood tests or unrelated abdominal imaging or liver biopsy. Non-alcoholic fatty liver disease is less dangerous than NASH and usually does not progress to NASH or liver cirrhosis. [9], Cardiovascular system screening is considered mandatory by the EASL, as NAFLD outcomes often result in cardiovascular complications,[13] which can manifest as subclinical atherosclerosis, the cause of the majority of NAFLD-related deaths. [2][4][21], A new name, metabolic dysfunction associated fatty liver disease, was proposed after 70% of a panel of experts expressed support for this name. [4] For severely obese individuals, the prevalence of NAFLD rises over 90%, and for those with diabetes, over 60%, and up to 20% for normal-weight people. [13] The AASLD recommends the use of the NAS scoring system with or without the SAF score if deemed appropriate. ヒトにみられる非アルコール性脂肪性肝疾患( non-alcoholic fatty liver disease, NAFLD)、特に非アルコール性脂肪性肝炎(non-alcoholic steatohepatitis, NASH)の予防・改善に有効であり、安全性が高く、しかも、カフェインを含まず、経口摂取しやすいNAFLDの予防および/または治療に有用な、経口摂取用組成物を提供する。 [19][25] Although NAFLD has a genetic component, the American Association for the Study of Liver Diseases (AASLD) does not recommend screening family members as there is not enough confirmation of heritability,[4] although there is some evidence from familial aggregation and twin studies. 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