Publication: Intervención farmacológica frente a la esteatosis hepática no alcohólica
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2017-02
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Abstract
El hígado graso no alcohólico (HGNA) es una enfermedad caracterizada por una acumulación anormal de grasa en los hepatocitos en individuos que no consumen alcohol y en ausencia de otras enfermedades hepáticas que puedan desencadenar esteatosis. El HGNA puede progresar a esteatohepatitis no alcohólica (EHNA), en donde además de la acumulación de grasa hay daño tisular, inflamación y posible fibrosis. Actualmente se admite que la esteatosis es la manifestación hepática del Síndrome Metabólico, ya que la obesidad, la diabetes mellitus tipo 2 (DM tipo 2) y la hiperlipemia son patologías que desencadenan diferentes mecanismos moleculares que conducen al desarrollo del HGNA. Por tanto la terapia farmacológica actual para el HGNA se basa en el tratamiento de dichas patologías. En este trabajo se explican los mecanismos que desencadenan la esteatosis hepática se exponen las distintas opciones farmacológicas que se disponen hoy en día, atendiendo a su mecanismo de acción y sus efectos beneficiosos sobre esta patología. A pesar de que no existe ningún tratamiento específico para la enfermedad, la mayoría de los estudios coinciden en que la pérdida de peso parece ser un factor clave en la mejora del HGNA, y que los tratamientos farmacológicos deben acompañarse de modificaciones en la dieta y en el estilo de vida de los pacientes. Esta pérdida de peso ayuda a disminuir los riesgos cardiovasculares asociados al síndrome metabólico, algo muy importante ya que actualmente la mayor causa de mortalidad en pacientes con HGNA es por patología cardiovascular.
Nonalcoholic fatty liver disease (NAFLD) is characterized by lipid accumulation in the liver in the absence of a chronic increase in alcohol intake or another hepatic diseases. NAFLD can progress to Nonalcoholic steatohepatitis (NASH), a more aggressive form with hepatocyte necrosis, inflammation and often fibrosis. Nowadays NAFLD is considered to be the hepatic appearance of the metabolic syndrome because it is closely associated with obesity, diabetes mellitus type 2 and lipid accumulation. By that reason, pharmacological management of NAFLD includes treatment of these pathologies. This review explain the molecular mechanism that contribute to the hepatic steatosis and the different therapeutic options that are currently Este trabajo tiene una finalidad docente. La Facultad de Farmacia no se hace responsable de la información contenida en el mismo. 2 available, focusing on their mechanism of action and their benefit effects in the NAFLD. Although no specific drugs for the NAFLD exist, most of the studies agree on the importance of weight loss. Because of that, in addition to the pharmacological treatment, lifestyle modification with diet and exercise are the cornerstone of therapy. Weight loss would help to decrease de cardiovascular risk, a priority in the management of the disease due to some investigators have shown that NAFLD is associated with higher cardiovascular disease.
Nonalcoholic fatty liver disease (NAFLD) is characterized by lipid accumulation in the liver in the absence of a chronic increase in alcohol intake or another hepatic diseases. NAFLD can progress to Nonalcoholic steatohepatitis (NASH), a more aggressive form with hepatocyte necrosis, inflammation and often fibrosis. Nowadays NAFLD is considered to be the hepatic appearance of the metabolic syndrome because it is closely associated with obesity, diabetes mellitus type 2 and lipid accumulation. By that reason, pharmacological management of NAFLD includes treatment of these pathologies. This review explain the molecular mechanism that contribute to the hepatic steatosis and the different therapeutic options that are currently Este trabajo tiene una finalidad docente. La Facultad de Farmacia no se hace responsable de la información contenida en el mismo. 2 available, focusing on their mechanism of action and their benefit effects in the NAFLD. Although no specific drugs for the NAFLD exist, most of the studies agree on the importance of weight loss. Because of that, in addition to the pharmacological treatment, lifestyle modification with diet and exercise are the cornerstone of therapy. Weight loss would help to decrease de cardiovascular risk, a priority in the management of the disease due to some investigators have shown that NAFLD is associated with higher cardiovascular disease.