Abstract
BackgroundWe recently examined the distribution of abdominal fat, dietary intake and biochemical data in patients with nonalcoholic fatty liver disease (NAFLD) and found that non-obese NAFLD patients did not necessarily exhibit insulin resistance and/or dysregulated secretion of adipocytokines. However, dietary cholesterol intake was superabundant in non-obese patients compared with obese patients, although total energy and carbohydrate intake was not excessive. Therefore, excess cholesterol intake appears to be one of the main factors associated with NAFLD development and liver injury.MethodsWe reviewed a year of follow-up data of non-obese NAFLD patients treated with Niemann-Pick C1 like 1 inhibitor ezetimibe to evaluate its therapeutic effect on clinical parameters related to NAFLD. Without any dietary or exercise modification, 10 mg/day of ezetimibe was given to 8 patients. In 4 of 8 patients, ezetimibe was administered initially. In the remaining 4 patients, medication was switched from ursodeoxycholic acid to ezetimibe.ResultsIn each patient, body mass index was maintained under 25 kg/m2 during the observation period. Serum ALT levels significantly decreased within 6 months and in 4 patients levels reached the normal range (<30 U/L), which was accompanied with at least a 10% decrease in serum total cholesterol and LDL-cholesterol. However, ultrasonographic findings of fatty liver did not show obvious improvement for a year.ConclusionWe conclude that the cholesterol absorption inhibitor ezetimibe can suppress hepatic injury in non-obese patients with NAFLD and that ezetimibe may offer a novel treatment for NAFLD.
Highlights
We recently examined the distribution of abdominal fat, dietary intake and biochemical data in patients with nonalcoholic fatty liver disease (NAFLD) and found that non-obese NAFLD patients did not necessarily exhibit insulin resistance and/or dysregulated secretion of adipocytokines
Nonalcoholic fatty liver disease (NAFLD), which is characterized by hepatic steatosis, is a common cause of abnormal liver function and its incidence is increasing in many countries
Many NAFLD patients progress to a severe form of nonalcoholic steatohepatitis that can lead to cirrhosis, hepatic failure and hepatocellular carcinoma [1,2]
Summary
We recently examined the distribution of abdominal fat, dietary intake and biochemical data in patients with nonalcoholic fatty liver disease (NAFLD) and found that non-obese NAFLD patients did not necessarily exhibit insulin resistance and/or dysregulated secretion of adipocytokines. Dietary cholesterol intake was superabundant in non-obese patients compared with obese patients, total energy and carbohydrate intake was not excessive. Nonalcoholic fatty liver disease (NAFLD), which is characterized by hepatic steatosis, is a common cause of abnormal liver function and its incidence is increasing in many countries. Obesity and/or insulin resistance are considered to be a common cause of NAFLD, a large proportion of NAFLD patients are non-obese individuals [3,4]. We evaluate the therapeutic effect of ezetimibe on non-obese NAFLD patients from the viewpoints of hepatic injury, dyslipidemia, and ultrasonographic fatty change. Ezetimibe had a prompt and excellent clinical effect on laboratory findings except for imaging
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