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478 NAFLD and CVD - Importance and Therapies

hepatitis A and B if they are not already immune, the
pneumococcal vaccine, and standard age-appropriate
vaccinations.
3.All patients avoid heavy alcohol consumption. In
patients with or at risk for NAFLD, heavy alcohol use
is associated with hepatic steatosis, hepatic injury,
and fibrosis.
4.Management of patients with NAFLD includes
optimization of blood glucose control in patients
with diabetes and treatment of hyperlipidemia. Statin
therapy has been shown to be safe in patients with
NAFLD.
5.Vitamin E is given for patients with advanced
fibrosis on biopsy who do not have diabetes or
coronary artery disease.
6.Thiazolidinediones improve histologic parameters
in patients with NASH, but likely need to be used
long-term and their use has been associated with
serious adverse events.
7.Patients with NASH-related cirrhosis should
undergo screening for HCC.
References
1. Torres DM, Williams CD, Harrison SA. Features, diagnosis, and treat-
ment of nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2012;
10:837.
2. Adams LA, Lymp JF, St Sauver J, et al. The natural history of nonalcohol-
ic fatty liver disease: a population-based cohort study. Gastroenterology
2005; 129:113.
3. Barker KB, Palekar NA, Bowers SP, et al. Non-alcoholic steatohepatitis:
effect of Roux-en-Y gastric bypass surgery. Am J Gastroenterol 2006;
101:368.
4. Harrison SA, Torgerson S, Hayashi P, et al. Vitamin E and vitamin C
treatment improves fibrosis in patients with nonalcoholic steatohepatitis.
Am J Gastroenterol 2003; 98:2485.
5. Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or
placebo for nonalcoholic steatohepatitis. N Engl J Med 2010; 362:1675.
6. Rinella ME. Nonalcoholic fatty liver disease: a systematic review. JAMA.
2015;313:2263–2273. doi: 10.1001/jama.2015.5370. [PubMed] [Cross
Ref]
7. Ahmed A, Wong RJ, Harrison SA. Nonalcoholic fatty liver disease review:
diagnosis, treatment and outcomes. Clin Gastroenterol Hepatol 13:2062-
2070 [PubMed]

GCDC 2017