Non-alcoholic Fatty Liver Disease: East Versus West

J Clin Exp Hepatol. 2012 Jun;2(2):122-34. doi: 10.1016/S0973-6883(12)60101-7. Epub 2012 Jul 21.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is an important cause of liver disease worldwide with prevalence ranging from 10% to 30% in various countries. It has become an important cause of unexplained rise in transaminases, cryptogenic cirrhosis, and cryptogenic hepatocellular carcinoma. Pathogenesis is related to obesity, insulin resistance, oxidative stress, lipotoxicity, and resultant inflammation in the liver progressing to fibrosis. Pharmacological treatment in patients with NAFLD is still evolving and the treatment of these patients rests upon lifestyle modification with diet and exercise being the cornerstones of therapy. While there are many similarities between patients with NAFLD from Asia and the West, there are certain features which make the patients with NAFLD from Asia stand apart. This review highlights the data on NAFLD from Asia comparing it with the data from the West.

Keywords: ALT, alanine aminotransferases; APO C3, apolipoprotein C3; CC, cryptogenic cirrhosis; CLD, chronic liver disease; Cirrhosis; DM, diabetes mellitus; FRAP, ferric-reducing ability of plasma; GSH, glutathione; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HDL, high-density lipoprotein; HTN, hypertension; IR, insulin resistance; ITT, insulin tolerance test; MS, metabolic syndrome; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; PCC, protein carbonyl; PNPLA3, patatin-like phospholipase domain-containing protein 3; SOD, superoxide dismutase; TBARS, thiobarbituric acid reactive substances; TG, triglyceride; TGF-β, transforming growth factor-beta; TNF-α, tumor necrosis factor-alfa; VLDL, very low density lipoproteins; diabetes mellitus; gene mutations; insulin resistance; metabolic syndrome; non-alcoholic steatohepatitis.