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Treatment of non-alcoholic fatty liver disease
  1. L A Adams1,
  2. P Angulo2
  1. 1School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Perth, Australia
  2. 2Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, USA
  1. Correspondence to:
 Dr P Angulo
 Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA; angulohernandez.paul{at}


Non-alcoholic fatty liver disease (NAFLD) is common and may progress to cirrhosis and its complications. The pathogenesis of steatosis and cellular injury is thought to be related mostly to insulin resistance and oxidative stress. Therefore, management entails identification and treatment of metabolic risk factors, improving insulin sensitivity, and increasing antioxidant defences in the liver. Weight loss and exercise improve insulin sensitivity. Bariatric surgery may improve liver histology in patients with morbid obesity. Insulin sensitising drugs showed promise in pilot trials as have a number of hepatoprotective agents. Further randomised, well controlled trials are required to determine the efficacy of these drugs.

  • NAFLD, non-alcoholic fatty liver disease
  • ALT, alanine aminotransferase
  • AST, aspartate aminotransferase
  • NASH, non-alcoholic steatohepatitis
  • non-alcoholic fatty liver disease
  • insulin resistance
  • treatment
  • weight loss
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  • Funding: LA is sponsored by a Postgraduate Medical Research Scholarship (no 353710) from the National Health and Medical Research Council as well as by the Athelstan and Amy Saw Postgraduate Medical Scholarship from The University of Western Australia.

  • Conflicts of interest: none declared.

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