Histological analysis of hypoglycemic agents on liver fibrosis in patients with non-alcoholic fatty liver disease: a systematic review
Abstract
To the Editor: Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of disease: simple steatosis, non-alcoholic steatohepatitis (NASH), and the related fibrosis and cirrhosis.[1] The treatment of NAFLD should aim to reverse or prevent liver fibrosis, which is associated with liver-specific morbidity or mortality, rather than just to reduce circulating liver enzyme activities and improve NASH. In addition to progressing to severe liver diseases, NAFLD is often associated with metabolic disorders such as insulin resistance (IR) and type 2 diabetes (T2D),[1] the coexistence of which accelerates the progression of NAFLD and increases the associated cardiovascular risk.[2] Thus, the prevention, slowing, or reversal of liver fibrosis is important in patients with NAFLD and T2D. Hypoglycemic agents that also improve liver fibrosis will be of use in such patients, and numerous studies are being conducted regarding the effects of hypoglycemic agents on the liver fibrosis and exploring the possible molecular targets.[3] The gold-standard method for the evaluation of liver fibrosis is the histological assessment of liver biopsies, but this is an invasive technique with limited use clinically. Instead, a number of non-invasive methods are now considered to be acceptable substitutes, including vibration-controlled transient elastography (VCTE) and magnetic resonance imaging (MRI).[2] To date, with a lack of histological evidence, the optimal choice of hypoglycemic agent for…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 247 participants or records.
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