Various treatment modalities of nafld: a systematic review
Abstract
Non-Alcoholic Fatty Liver Disease (NAFLD) is a prevalent hepatic condition characterized by excessive fat accumulation in the liver. With the rising global burden of NAFLD, various therapeutic approaches have emerged across different systems of medicine, including Ayurveda, Homeopathy, Allopathy, Siddha, and Unani. This comprehensive review article aims to provide an integrative analysis of the treatments available for NAFLD in these diverse systems, highlighting their unique principles, herbal formulations, dietary recommendations, and lifestyle modifications. In addition to these treatment strategies, various surgical interventions are also available to treat this fatal liver disease. We explore the existing scientific evidence, clinical efficacy, and safety profiles of these treatments. By synthesizing insights from multiple healing traditions, this review facilitates a holistic understanding of NAFLD management, fostering potential cross-disciplinary collaborations and personalized therapeutic strategies. The comparative evaluation of these treatments contributes to a broader perspective on addressing the complex issue of NAFLD, emphasizing the importance of individualized care in the management of this increasingly prevalent liver disorder.
Keywords:
NAFLD, Ayurveda, Homeopathy, Allopathy, Siddha, Unani
Downloads
Download data is not yet available.
References
1. Sahu A.K, Upadhyay A, Bhakuni H, Attanayake A.M.H.S. and Sharma P. Effect of Ayurveda interventions in non-alcoholic grade II fatty liver associated with obesity–A case report. Journal of Ayurveda and Integrative Medicine. 2022; 13(3): p.100605.
2. Riazi K, Azhari H, Charette J.H, Underwood F.E, King J.A, Afshar E.E, Swain M.G, Congly S.E, Kaplan G.G. and Shaheen, A.A. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. The Lancet Gastroenterology & Hepatology. 2022.
3. Younossi Z.M, Koenig A.B, Abdelatif D, Fazel Y, Henry L. and Wymer M. Global epidemiology of non-alcoholic fatty liver disease—meta‐analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016; 64(1); pp.73-84.
4. Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G. and Bellentani S. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology.2005; 42(1): pp.44-52.
5. Ratziu V, Bellentani S, Cortez-Pinto H, Day C. and Marchesini, G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. Journal of hepatology. 2010; 53(2), pp.372-384.
6. Elhence A, Bansal B, Gupta H, Anand A, Singh T.P. and Goel A. Prevalence of non-alcoholic fatty liver disease in India: a systematic review and meta-analysis. Journal of Clinical and Experimental Hepatology. 2022; 12(3): pp.818-829.
7. Mitra S, De A. and Chowdhury A. Epidemiology of non-alcoholic and alcoholic fatty liver diseases. Translational gastroenterology and hepatology, 5; 2020.
8. Kneeman J.M, Misdraji J. and Corey K.E. Secondary causes of non-alcoholic fatty liver disease. Therapeutic advances in gastroenterology. 2012; 5(3): pp.199-207.
9. Franco, Lissa, Jones-Pauley, Michelle , Tamimi, Omar , Neshatian, Leila M, Nguyen, Duc , Graviss, Edward, Quigley, Eamonn MM, Victor, David III. Irritable Bowel Syndrome Symptoms in Nonalcoholic Fatty Liver Disease Patients Are an Indicator of Depression and Anxiety. Journal of Clinical Gastroenterology ():10.1097/MCG.0000000000001770, October 10, 2022. | DOI: 10.1097/MCG.0000000000001770
10. Catanzaro R, Calabrese F, Occhipinti S. et al. Non-alcoholic Fatty Liver Disease Increases Risk for Gastroesophageal Reflux Symptoms. Dig Dis Sci 59, 1939–1945 (2014). https://doi.org/10.1007/s10620-014-3113-7
11. Carr RM, Oranu A, Khungar V. Nonalcoholic fatty liver disease: pathophysiology and management. Gastroenterology Clinics. 2016 Dec 1;45(4):639-52.
12. Raschi E, Mazzotti A, Poluzzi E, De Ponti F, Marchesini, G. Pharmacotherapy of type 2 diabetes in patients with chronic liver disease: Focus on nonalcoholic fatty liver disease. Expert Opin. Pharmacother. 2018, 19, 1903–1914.
13. Traci E LaMoia, Gerald I Shulman, Cellular and Molecular Mechanisms of Metformin Action, Endocrine Reviews, Volume 42, Issue 1, February 2021, Pages 77–96.
14. McCreight LJ, Mari A, Coppin L, Jackson N, Umpleby AM, Pearson ER. Metformin increases fasting glucose clearance and endogenous glucose production in non-diabetic individuals. Diabetologia.2020; 63(2):444-447.
15. Galuska D, Nolte LA, Zierath JR, Wallberg-Henriksson H. Effect of metformin on insulin-stimulated glucose transport in isolated skeletal muscle obtained from patients with NIDDM. Diabetologia.1994; 37(8):826-832.
16. Inzucchi SE , Maggs DG, Spollett GR, et al. Efficacy and metabolic effects of metformin and troglitazone in type II diabetes mellitus. N Engl J Med.1998; 338(13): 867-872.
17. Stumvoll M, Nurjhan N, Perriello G, Dailey G, Gerich JE. Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Engl J Med.1995; 333(9): 550-554.
18. Reaven GM. Role of insulin resistance in human disease. Diabetes.1988; 37:1595.
19. Magnusson I, Rothman DL, Katz LD, Shulman RG, Shulman GI. Increased rate of gluconeogenesis in type II diabetes mellitus. A 13C nuclear magnetic resonance study. J Clin Invest.1992; 90(4): 1323-1327.
20. Nosadini R , Avogaro A, Trevisan R, et al. Effect of metformin on insulin-stimulated glucose turnover and insulin binding to receptors in type II diabetes. Diabetes Care.1987; 10(1): 62-67.
21. Johnson AB, Webster JM, Sum CF, et al. The impact of metformin therapy on hepatic glucose production and skeletal muscle glycogen synthase activity in overweight type II diabetic patients. Metabolism.1993; 42(9): s1217-1222.
22. Widén EI, Eriksson JG, Groop LC. Metformin normalizes nonoxidative glucose metabolism in insulin-resistant normoglycemic first-degree relatives of patients with NIDDM.
23. DeFronzo RA, Goodman AM. Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. N Engl J Med.1995; 333: 541-549.
24. American Diabetes Association. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes— 2019. Diabetes Care 2019, 42 (Suppl. 1), S90–S102.
25. Raschi E, Mazzotti A, Poluzzi E, De Ponti F, Marchesini, G. Pharmacotherapy of type 2 diabetes in patients with chronic liver disease: Focus on nonalcoholic fatty liver disease. Expert Opin. Pharmacother. 2018, 19, 1903–1914.
26. Francque S, Szabo G, Abdelmalek M.F, Byrne C.D, Cusi K Dufour J.-F, Roden M, Sacks F, Tacke, F. Non-alcoholic steatohepatitis: The role of peroxisome proliferator-activated receptors. Nat. Rev. Gastroenterol. Hepatol. 2021, 18, 24–39.
27. Mantovani A, Byrne C, Scorletti E, Mantzoros C, Targher G. Efficacy and safety of anti-hyperglycaemic drugs in patients with non-alcoholic fatty liver disease with or without diabetes: An updated systematic review of randomized controlled trials. Diabetes Metab. 2020, 46, 427–441.
28. Kalavalapalli S, Bril F, Guingab J, Vergara A, Garrett T.J, Sunny N.E, Cusi K. Impact of exenatide on mitochondrial lipid metabolism in mice with nonalcoholic steatohepatitis. J. Endocrinol. 2019, 241, 293–305.
29. Katsiki N, Perakakis N, Mantzoros C. Effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors on non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: Ex quo et quo vadimus? Metabolism 2019, 98
30. Chauhan A, Semwal DK, Mishra SP, Semwal RB. Ayurvedic research and methodology: Present status and future strategies. Ayu. 2015 Oct;36(4):364.
31. Semwal DK, Mishra SP, Chauhan A, Semwal RB. Adverse health effects of tobacco and role of Ayurveda in their reduction. J Med Sci. 2015; 15:139–46
32. Sahu AK, Upadhyay A, Bhakuni H, Attanayake AM, Sharma P. Effect of Ayurveda interventions in non-alcoholic grade II fatty liver associated with obesity–A case report. Journal of Ayurveda and Integrative Medicine. 2022 Jul 1; 13(3): 100605.
33. Pandya MG, Dave AR. A clinical study of Punarnava Mandura in the management of Pandu Roga in old age (geriatric anemia). Ayu 2014; 35(3): 252e60. https://doi.org/10.4103/0974-8520.153735.
34. Rawat AK, Mehrotra S, Tripathi SC, Shome U. Hepatoprotective activity of Boerhaaviadiffusa L. roots e a popular Indian ethnomedicine. J Ethnopharmacol 1997 Mar;56(1):61e6. https://doi.org/10.1016/s0378-8741(96)01507-3.
35. Wei X, Luo C, He Y, Huang H, Ran F, Liao W, et al. Hepatoprotective effects of different extracts from Triphala against CCl4-induced acute liver injury in mice. Front Pharmacol2021;12:664607. https://doi.org/10.3389/fphar.
36. Sayyad Roohullah, Zahid Khan. Review on Non-Alcoholic Fatty Liver Disease and its Homoeopathic Treatment. International Journal of Research in AYUSH and Pharmaceutical Sciences, 2017;1(6):184- 192
37. Homeopathy, Volume 104, Issue 1, January 2015, Pages 29-35. 38.
38. Homeopathic Remedies for Fatty Liver, available as; https://www.lybrate.com /topic/ homeopathy-and-fatty-liver/ 21520b7332ac 1240b4241f0573f123e1.
39. Carmel Casserley discusses how homeopathy can help; available as; https://www. british homeopathic.org/charity/how-we-canhelp/articles/conditions/l/liver-problems/
40. Natural Homeopathic Remedies for Fatty Liver, available as; https://www.drhomeo.com /liver/top-5-natural-homeopathic-remedies-forfatty-liver/
41. Homeopathy for liver diseases & Liver failure - Hpathy Ezine, May, 2014. 27.
42. Homeopathic materia medica by William Boericke, M.D. Presented by Médi-T
43. www.homeopathicremediesblog.com/remedies/podophyllum-peltatum/
44. A Text-Book of Materia Medica. (Characteristic, Analytical, and Comparative.) By Pr. Allen Corson Cowperthwaite, M. D., PH. D., LL. D
45. Lectures on homśopathicmateria medica by jamestylerkent, A.M., M.D. Late Professor of Materia Medica in Hering College, Chicago. Presented by Dr Robert Séror
46. Homoeopathic Remedies For Liver Cancer; https://www.ks-gopi.blogspot.com/2017/ 06/ homoeopathic-remedies-for-liver-cancer.html
47. Boericke W. Pocket Manual of Homoeopathic Materia Medica & Repertory. Reprint. 9th ed. New Delhi: B. Jain Publishers (Pvt.) Ltd, 2002.
48. Clarke JH. A Dictionary of Practical Materia Medical. 3 rd New Delhi: B. Jain Publishers (Pvt.) Ltd.
49. Kandasamy PN. History of Siddha Medicine, Department of Indian Medicine - Homeopathy, Chennai-106, 2nd Edition 1998; 283.
50. Siddha Medicine: Tamil ValarchiKazhagam, University building, Chepauk, Chennai-5, 1st Edition, 2010, p. 27.
51. SKM Siddha and Ayurveda Company. Therapeutic Index Siddha (Hospital Pharmacopoeia). 1st ed. India: SKM Siddha and Ayurveda Company; 2010. p. 166-7.
52. Velayudam, Ilavarasan, Amuthan A. Physico-chemical evaluation of kadukkaimaathirai and its tablet formulation, a siddha iron preparation used in anemia. Int J Pharmacol Clin Sci 2012;1:3-8.
53. Tasduq SA, Singh K, Satti NK, Gupta DK, Suri KA. Terminalia chebula (fruit) prevents liver toxicity caused by sub-chronic administration of rifampicin, isoniazid and pyrazinamide in combination. Hum Exp Toxicol2006;25:111-8.
54. Nirwane AM, Bapat AR. Effect of methanolic extract of Piper nigrum fruit in ethanhol-CCl4induced hepatotoxicity in wistar rats. Pharm Lett 2012;4:795-802.
55. Bai X, Zhang W, Chen W, Zong W, Guo Z, Liu X. Anti-hepatotoxic and antioxidant effects of extracts from Piper nigrum L. root. Afr J Biotechnol2011;10:267-72.
56. Bhavsar SK, Joshi P, Shah MB, Santani DD. Investigation into hepatoprotective activity of Citrus limon. J Pharm Biol2007;45:303-11.
57. Saxena AK, Singh B, Anand KK. Hepatoprotective effects of Eclipta alba on subcellular levels in rats. J Ethnopharmacol1993;40:156-61.
58. Thirumalai T, David E, Therasa SV, Elumalai EK. Restorative effect of Eclipta alba in CCl4 induced hepatotoxicity in male albino rats. Asian Pac J Trop Dis 2011;1:304-7.
59. Shetty MA, Shenoy S, Devi V, Kumar N, Amuthan A, Shenoy GK, Pavithra P. Protective Effect OfKadukkaiMaathirai (Terminalia Chebula-Based Polyherbal Siddha Formulation) In Ethanol-Induced Liver Disease In Rats. Asian J Pharm Clin Res. 2018 Jan 1;11(11):368-71.
60. Ibn Sina(2010). Al qanoon fit tib. (Urdu Translation by Ghulam Hussain Kantoori). New Delhi: IdaraKitabulshifa; Vol 3:854-64. 33. Ibn Rushd(1987). KitabulKulliyat. (Urdu Translation by C.C.R.U.M) New Delhi: C.C.R.U.M; 26,35,46,49.
61. Razi Z. Kitab Al Hawi. Vol.7. New Delhi: C.C.R.U.M; 2000. p. 47-85.
62. Ibn Zuhr AM(1986). KitabutTaiseer. New Delhi: C.C.R.U.M; p.114.
63. Akbar Arzani. Tibbe Akbar. Vol.2. Deoband (India): Faisal publications; YNM. p. 439-42.
64. TabriAHAM. MoalajateBukhratia. 1997. Vol.3. New Delhi: C.C.R.U.M; p.191, 202.
65. Khan MA. AkseerAzam(2011). (Urdu translation by Kabeeruddin M) New Delhi: Idarakitabulshifa; p. 481 -98.
66. Baghdadi IH(2004). KitabulMukhtarat fit Tib. Vol.3. New Delhi: C.C.R.U.M; p. 272-75.
67. Vickers A, Wilson P, Kleijnen J. Acupuncture. Quality & safety in health care. 2002 Mar;11(1):92.
68. Dong C, Zhang C-R, Xue B-Y, et al. Electroacupuncture combined with lifestyle control on obese non-alcoholic fatty liver disease: a randomized controlled trial. Zhongguo Zhen Jiu 2020;40: 129–34.
69. Zhu L-L, Wei W-M, Zeng Z-H, et al. Impact of electro-acupuncture on lipid metabolism in rats with non-alcoholic fatty liver disease. Sichuan Da Xue Xue Bao Yi Xue Ban 2012; 43: 847–50.
70. Meng X, Guo X, Zhang J, et al. Acupuncture on ST36, CV4 and KI1 suppresses the progression of methionine- and choline-deficient diet induced non-alcoholic fatty liver disease in mice. Metabolites 2019; 9:299.
71. Ahmad W, Sofi G, Alam MA, Zulkifle M, Ahmad B. Understanding Holism in the light of principle underlying practice of Unani Medicine. Rev Environ Health. 2021 May 13;37(2):189-199. doi: 10.1515/reveh-2021-0009. Print 2022 Jun 27.
72. Concon AA. Unani medicine. Am J Chin Med. 1983;11(1-4):166-7.
73. Jabin F. A guiding tool in Unani Tibb for maintenance and preservation of health: a review study Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):140-3. doi: 10.4314/ajtcam.v8i5S.7. Epub 2011 Jul 3.
74. Asim Ali Khan, Rajiv Janardhanan, Jugal Kishore, Ritu Karwasra, Shazina Saeed, B.C Das, Nazeer Hasan, Waleed H. Almalki, Prashant Kesharwani, W Selvamurthy. Unani System Of Medicine And It's Development In Contemporary Healthcare: A Comprehensive Review. Journal of Pharmaceutical Negative Resultsm. Volume 13. Special Issue 9,2022.
75. Dufour J–F, Caussy C, Loomba R. Bariatric surgery in patients with non–alcoholic fatty liver disease – from pathophysiology to clinical effects. World J Hepatol. 2019; 11: 1877–84.
76. Klein S, Mittendorfer B, Eagon JC, Patterson B, Grant L, Feirt N, Seki E, Brenner D, Korenblat K, McCrea J. Gastric bypass surgery improves metabolic and hepatic abnormalities associated with nonalcoholic fatty liver disease. Gastroenterology. 2006; 130(6): 1564–72. doi: 10.1053/j.gastro.2006.01.042.
77. Gastrointestinal surgery for severe obesity. NIH consensus development conference, March 25-7,1991. Nutrition. 1996;12(6):397–404.
78. Burguera B, Agusti A, Arner P, Baltasar A, Barbe F, Barcelo A, Breton I, Cabanes T, Casanueva JF, Couce JE, Dieguez C, et al. Critical assessment of the current guidelines for the management and treatment of morbidly obese patients. J Endocrinol Invest. 2007;30(10):844–52. doi: 10.1007/bf03349226.
79. Bower G, Toma T, Harling L, Jiao LR, Efthimiou E, Darzi A, Athanasiou T, Ashrafian H. Bariatric Surgery and Non-Alcoholic Fatty Liver Disease: a Systematic Review of Liver Biochemistry and Histology. Obes Surg. 2015;25(12):2280–9. doi: 10.1007/s11695-015-1691-x.
80. Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition. 2009; 25(11–12): 1150–6. doi: 10.1016/j.nut.2009.03.012.
81. de Jonge C, Rensen SS, Koek GH, et al. Endoscopic duodenal-jejunal bypass liner rapidly improves plasma parameters of nonalcoholic fatty liver disease. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2013; 11(11): 1517–20. doi: 10.1016/j.cgh.2013.07.029 [published Online First: Epub Date]
82. Ricci G, Bersani G, Rossi A, Pigo F, De Fabritiis G, Alvisi V. Bariatric therapy with intragastric balloon improves liver dysfunction and insulin resistance in obese patients. Obesity surgery. 2008; 18(11): 1438–42. doi: 10.1007/s11695-008-9487-x[published Online First: Epub Date].
83. Lee YM, Low HC, Lim LG, et al. Intragastric balloon significantly improves nonalcoholic fatty liver disease activity score in obese patients with nonalcoholic steatohepatitis: a pilot study. Gastrointestinal endoscopy. 2012; 76(4): 756–60. doi: 10.1016/j.gie.2012.05.023[published Online First: Epub Date].
84. Corey K. E & Rinella M. E. Medical and Surgical Treatment Options for Nonalcoholic Steatohepatitis. Digestive diseases and sciences, 2016. 61(5): 1387–1397. https://doi.org/10.1007/s10620-016-4083-8.
85. Bazerbachi F, Vargas E. J, Rizk M Maselli D. B, Mounajjed T, Venkatesh S. K, Watt K. D, Port J. D, Basu R, Acosta A, Hanouneh I, Gara N, Shah M, Mundi M, Clark M, Grothe K, Storm A. C, Levy M. J, & Abu Dayyeh B. K. Intragastric Balloon Placement Induces Significant Metabolic and Histologic Improvement in Patients With Nonalcoholic Steatohepatitis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. 19(1), 146–154.e4. https://doi.org/10.1016/j.cgh.2020.04.068
86. Bazerbachi F, Vargas E. J, Rizk M, Maselli D. B, Mounajjed T, Venkatesh S. K, Watt K. D, Port J. D, Basu R, Acosta, Hanouneh I, Gara N, Shah M, Mundi M, Clark M, Grothe K, Storm A. C, Levy M. J & Abu Dayyeh, B. K.. Intragastric Balloon Placement Induces Significant Metabolic and Histologic Improvement in Patients With Nonalcoholic Steatohepatitis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. 19(1), 146–154.e4. https://doi.org/10.1016/j.cgh.2020.04.068
87. Roehlen N, Laubner K, Nicolaus L, Schwacha H, Bettinger D, Krebs A, Thimme R & Seufert, J.. Impact of duodenal-jejunal bypass liner (DJBL) on NAFLD in patients with obesity and type 2 diabetes mellitus. Nutrition (Burbank, Los Angeles County, Calif.). 2022: 103-104, 111806. https://doi.org/10.1016/j.nut.2022.111806
2. Riazi K, Azhari H, Charette J.H, Underwood F.E, King J.A, Afshar E.E, Swain M.G, Congly S.E, Kaplan G.G. and Shaheen, A.A. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. The Lancet Gastroenterology & Hepatology. 2022.
3. Younossi Z.M, Koenig A.B, Abdelatif D, Fazel Y, Henry L. and Wymer M. Global epidemiology of non-alcoholic fatty liver disease—meta‐analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016; 64(1); pp.73-84.
4. Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G. and Bellentani S. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology.2005; 42(1): pp.44-52.
5. Ratziu V, Bellentani S, Cortez-Pinto H, Day C. and Marchesini, G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. Journal of hepatology. 2010; 53(2), pp.372-384.
6. Elhence A, Bansal B, Gupta H, Anand A, Singh T.P. and Goel A. Prevalence of non-alcoholic fatty liver disease in India: a systematic review and meta-analysis. Journal of Clinical and Experimental Hepatology. 2022; 12(3): pp.818-829.
7. Mitra S, De A. and Chowdhury A. Epidemiology of non-alcoholic and alcoholic fatty liver diseases. Translational gastroenterology and hepatology, 5; 2020.
8. Kneeman J.M, Misdraji J. and Corey K.E. Secondary causes of non-alcoholic fatty liver disease. Therapeutic advances in gastroenterology. 2012; 5(3): pp.199-207.
9. Franco, Lissa, Jones-Pauley, Michelle , Tamimi, Omar , Neshatian, Leila M, Nguyen, Duc , Graviss, Edward, Quigley, Eamonn MM, Victor, David III. Irritable Bowel Syndrome Symptoms in Nonalcoholic Fatty Liver Disease Patients Are an Indicator of Depression and Anxiety. Journal of Clinical Gastroenterology ():10.1097/MCG.0000000000001770, October 10, 2022. | DOI: 10.1097/MCG.0000000000001770
10. Catanzaro R, Calabrese F, Occhipinti S. et al. Non-alcoholic Fatty Liver Disease Increases Risk for Gastroesophageal Reflux Symptoms. Dig Dis Sci 59, 1939–1945 (2014). https://doi.org/10.1007/s10620-014-3113-7
11. Carr RM, Oranu A, Khungar V. Nonalcoholic fatty liver disease: pathophysiology and management. Gastroenterology Clinics. 2016 Dec 1;45(4):639-52.
12. Raschi E, Mazzotti A, Poluzzi E, De Ponti F, Marchesini, G. Pharmacotherapy of type 2 diabetes in patients with chronic liver disease: Focus on nonalcoholic fatty liver disease. Expert Opin. Pharmacother. 2018, 19, 1903–1914.
13. Traci E LaMoia, Gerald I Shulman, Cellular and Molecular Mechanisms of Metformin Action, Endocrine Reviews, Volume 42, Issue 1, February 2021, Pages 77–96.
14. McCreight LJ, Mari A, Coppin L, Jackson N, Umpleby AM, Pearson ER. Metformin increases fasting glucose clearance and endogenous glucose production in non-diabetic individuals. Diabetologia.2020; 63(2):444-447.
15. Galuska D, Nolte LA, Zierath JR, Wallberg-Henriksson H. Effect of metformin on insulin-stimulated glucose transport in isolated skeletal muscle obtained from patients with NIDDM. Diabetologia.1994; 37(8):826-832.
16. Inzucchi SE , Maggs DG, Spollett GR, et al. Efficacy and metabolic effects of metformin and troglitazone in type II diabetes mellitus. N Engl J Med.1998; 338(13): 867-872.
17. Stumvoll M, Nurjhan N, Perriello G, Dailey G, Gerich JE. Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Engl J Med.1995; 333(9): 550-554.
18. Reaven GM. Role of insulin resistance in human disease. Diabetes.1988; 37:1595.
19. Magnusson I, Rothman DL, Katz LD, Shulman RG, Shulman GI. Increased rate of gluconeogenesis in type II diabetes mellitus. A 13C nuclear magnetic resonance study. J Clin Invest.1992; 90(4): 1323-1327.
20. Nosadini R , Avogaro A, Trevisan R, et al. Effect of metformin on insulin-stimulated glucose turnover and insulin binding to receptors in type II diabetes. Diabetes Care.1987; 10(1): 62-67.
21. Johnson AB, Webster JM, Sum CF, et al. The impact of metformin therapy on hepatic glucose production and skeletal muscle glycogen synthase activity in overweight type II diabetic patients. Metabolism.1993; 42(9): s1217-1222.
22. Widén EI, Eriksson JG, Groop LC. Metformin normalizes nonoxidative glucose metabolism in insulin-resistant normoglycemic first-degree relatives of patients with NIDDM.
23. DeFronzo RA, Goodman AM. Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. N Engl J Med.1995; 333: 541-549.
24. American Diabetes Association. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes— 2019. Diabetes Care 2019, 42 (Suppl. 1), S90–S102.
25. Raschi E, Mazzotti A, Poluzzi E, De Ponti F, Marchesini, G. Pharmacotherapy of type 2 diabetes in patients with chronic liver disease: Focus on nonalcoholic fatty liver disease. Expert Opin. Pharmacother. 2018, 19, 1903–1914.
26. Francque S, Szabo G, Abdelmalek M.F, Byrne C.D, Cusi K Dufour J.-F, Roden M, Sacks F, Tacke, F. Non-alcoholic steatohepatitis: The role of peroxisome proliferator-activated receptors. Nat. Rev. Gastroenterol. Hepatol. 2021, 18, 24–39.
27. Mantovani A, Byrne C, Scorletti E, Mantzoros C, Targher G. Efficacy and safety of anti-hyperglycaemic drugs in patients with non-alcoholic fatty liver disease with or without diabetes: An updated systematic review of randomized controlled trials. Diabetes Metab. 2020, 46, 427–441.
28. Kalavalapalli S, Bril F, Guingab J, Vergara A, Garrett T.J, Sunny N.E, Cusi K. Impact of exenatide on mitochondrial lipid metabolism in mice with nonalcoholic steatohepatitis. J. Endocrinol. 2019, 241, 293–305.
29. Katsiki N, Perakakis N, Mantzoros C. Effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors on non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: Ex quo et quo vadimus? Metabolism 2019, 98
30. Chauhan A, Semwal DK, Mishra SP, Semwal RB. Ayurvedic research and methodology: Present status and future strategies. Ayu. 2015 Oct;36(4):364.
31. Semwal DK, Mishra SP, Chauhan A, Semwal RB. Adverse health effects of tobacco and role of Ayurveda in their reduction. J Med Sci. 2015; 15:139–46
32. Sahu AK, Upadhyay A, Bhakuni H, Attanayake AM, Sharma P. Effect of Ayurveda interventions in non-alcoholic grade II fatty liver associated with obesity–A case report. Journal of Ayurveda and Integrative Medicine. 2022 Jul 1; 13(3): 100605.
33. Pandya MG, Dave AR. A clinical study of Punarnava Mandura in the management of Pandu Roga in old age (geriatric anemia). Ayu 2014; 35(3): 252e60. https://doi.org/10.4103/0974-8520.153735.
34. Rawat AK, Mehrotra S, Tripathi SC, Shome U. Hepatoprotective activity of Boerhaaviadiffusa L. roots e a popular Indian ethnomedicine. J Ethnopharmacol 1997 Mar;56(1):61e6. https://doi.org/10.1016/s0378-8741(96)01507-3.
35. Wei X, Luo C, He Y, Huang H, Ran F, Liao W, et al. Hepatoprotective effects of different extracts from Triphala against CCl4-induced acute liver injury in mice. Front Pharmacol2021;12:664607. https://doi.org/10.3389/fphar.
36. Sayyad Roohullah, Zahid Khan. Review on Non-Alcoholic Fatty Liver Disease and its Homoeopathic Treatment. International Journal of Research in AYUSH and Pharmaceutical Sciences, 2017;1(6):184- 192
37. Homeopathy, Volume 104, Issue 1, January 2015, Pages 29-35. 38.
38. Homeopathic Remedies for Fatty Liver, available as; https://www.lybrate.com /topic/ homeopathy-and-fatty-liver/ 21520b7332ac 1240b4241f0573f123e1.
39. Carmel Casserley discusses how homeopathy can help; available as; https://www. british homeopathic.org/charity/how-we-canhelp/articles/conditions/l/liver-problems/
40. Natural Homeopathic Remedies for Fatty Liver, available as; https://www.drhomeo.com /liver/top-5-natural-homeopathic-remedies-forfatty-liver/
41. Homeopathy for liver diseases & Liver failure - Hpathy Ezine, May, 2014. 27.
42. Homeopathic materia medica by William Boericke, M.D. Presented by Médi-T
43. www.homeopathicremediesblog.com/remedies/podophyllum-peltatum/
44. A Text-Book of Materia Medica. (Characteristic, Analytical, and Comparative.) By Pr. Allen Corson Cowperthwaite, M. D., PH. D., LL. D
45. Lectures on homśopathicmateria medica by jamestylerkent, A.M., M.D. Late Professor of Materia Medica in Hering College, Chicago. Presented by Dr Robert Séror
46. Homoeopathic Remedies For Liver Cancer; https://www.ks-gopi.blogspot.com/2017/ 06/ homoeopathic-remedies-for-liver-cancer.html
47. Boericke W. Pocket Manual of Homoeopathic Materia Medica & Repertory. Reprint. 9th ed. New Delhi: B. Jain Publishers (Pvt.) Ltd, 2002.
48. Clarke JH. A Dictionary of Practical Materia Medical. 3 rd New Delhi: B. Jain Publishers (Pvt.) Ltd.
49. Kandasamy PN. History of Siddha Medicine, Department of Indian Medicine - Homeopathy, Chennai-106, 2nd Edition 1998; 283.
50. Siddha Medicine: Tamil ValarchiKazhagam, University building, Chepauk, Chennai-5, 1st Edition, 2010, p. 27.
51. SKM Siddha and Ayurveda Company. Therapeutic Index Siddha (Hospital Pharmacopoeia). 1st ed. India: SKM Siddha and Ayurveda Company; 2010. p. 166-7.
52. Velayudam, Ilavarasan, Amuthan A. Physico-chemical evaluation of kadukkaimaathirai and its tablet formulation, a siddha iron preparation used in anemia. Int J Pharmacol Clin Sci 2012;1:3-8.
53. Tasduq SA, Singh K, Satti NK, Gupta DK, Suri KA. Terminalia chebula (fruit) prevents liver toxicity caused by sub-chronic administration of rifampicin, isoniazid and pyrazinamide in combination. Hum Exp Toxicol2006;25:111-8.
54. Nirwane AM, Bapat AR. Effect of methanolic extract of Piper nigrum fruit in ethanhol-CCl4induced hepatotoxicity in wistar rats. Pharm Lett 2012;4:795-802.
55. Bai X, Zhang W, Chen W, Zong W, Guo Z, Liu X. Anti-hepatotoxic and antioxidant effects of extracts from Piper nigrum L. root. Afr J Biotechnol2011;10:267-72.
56. Bhavsar SK, Joshi P, Shah MB, Santani DD. Investigation into hepatoprotective activity of Citrus limon. J Pharm Biol2007;45:303-11.
57. Saxena AK, Singh B, Anand KK. Hepatoprotective effects of Eclipta alba on subcellular levels in rats. J Ethnopharmacol1993;40:156-61.
58. Thirumalai T, David E, Therasa SV, Elumalai EK. Restorative effect of Eclipta alba in CCl4 induced hepatotoxicity in male albino rats. Asian Pac J Trop Dis 2011;1:304-7.
59. Shetty MA, Shenoy S, Devi V, Kumar N, Amuthan A, Shenoy GK, Pavithra P. Protective Effect OfKadukkaiMaathirai (Terminalia Chebula-Based Polyherbal Siddha Formulation) In Ethanol-Induced Liver Disease In Rats. Asian J Pharm Clin Res. 2018 Jan 1;11(11):368-71.
60. Ibn Sina(2010). Al qanoon fit tib. (Urdu Translation by Ghulam Hussain Kantoori). New Delhi: IdaraKitabulshifa; Vol 3:854-64. 33. Ibn Rushd(1987). KitabulKulliyat. (Urdu Translation by C.C.R.U.M) New Delhi: C.C.R.U.M; 26,35,46,49.
61. Razi Z. Kitab Al Hawi. Vol.7. New Delhi: C.C.R.U.M; 2000. p. 47-85.
62. Ibn Zuhr AM(1986). KitabutTaiseer. New Delhi: C.C.R.U.M; p.114.
63. Akbar Arzani. Tibbe Akbar. Vol.2. Deoband (India): Faisal publications; YNM. p. 439-42.
64. TabriAHAM. MoalajateBukhratia. 1997. Vol.3. New Delhi: C.C.R.U.M; p.191, 202.
65. Khan MA. AkseerAzam(2011). (Urdu translation by Kabeeruddin M) New Delhi: Idarakitabulshifa; p. 481 -98.
66. Baghdadi IH(2004). KitabulMukhtarat fit Tib. Vol.3. New Delhi: C.C.R.U.M; p. 272-75.
67. Vickers A, Wilson P, Kleijnen J. Acupuncture. Quality & safety in health care. 2002 Mar;11(1):92.
68. Dong C, Zhang C-R, Xue B-Y, et al. Electroacupuncture combined with lifestyle control on obese non-alcoholic fatty liver disease: a randomized controlled trial. Zhongguo Zhen Jiu 2020;40: 129–34.
69. Zhu L-L, Wei W-M, Zeng Z-H, et al. Impact of electro-acupuncture on lipid metabolism in rats with non-alcoholic fatty liver disease. Sichuan Da Xue Xue Bao Yi Xue Ban 2012; 43: 847–50.
70. Meng X, Guo X, Zhang J, et al. Acupuncture on ST36, CV4 and KI1 suppresses the progression of methionine- and choline-deficient diet induced non-alcoholic fatty liver disease in mice. Metabolites 2019; 9:299.
71. Ahmad W, Sofi G, Alam MA, Zulkifle M, Ahmad B. Understanding Holism in the light of principle underlying practice of Unani Medicine. Rev Environ Health. 2021 May 13;37(2):189-199. doi: 10.1515/reveh-2021-0009. Print 2022 Jun 27.
72. Concon AA. Unani medicine. Am J Chin Med. 1983;11(1-4):166-7.
73. Jabin F. A guiding tool in Unani Tibb for maintenance and preservation of health: a review study Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):140-3. doi: 10.4314/ajtcam.v8i5S.7. Epub 2011 Jul 3.
74. Asim Ali Khan, Rajiv Janardhanan, Jugal Kishore, Ritu Karwasra, Shazina Saeed, B.C Das, Nazeer Hasan, Waleed H. Almalki, Prashant Kesharwani, W Selvamurthy. Unani System Of Medicine And It's Development In Contemporary Healthcare: A Comprehensive Review. Journal of Pharmaceutical Negative Resultsm. Volume 13. Special Issue 9,2022.
75. Dufour J–F, Caussy C, Loomba R. Bariatric surgery in patients with non–alcoholic fatty liver disease – from pathophysiology to clinical effects. World J Hepatol. 2019; 11: 1877–84.
76. Klein S, Mittendorfer B, Eagon JC, Patterson B, Grant L, Feirt N, Seki E, Brenner D, Korenblat K, McCrea J. Gastric bypass surgery improves metabolic and hepatic abnormalities associated with nonalcoholic fatty liver disease. Gastroenterology. 2006; 130(6): 1564–72. doi: 10.1053/j.gastro.2006.01.042.
77. Gastrointestinal surgery for severe obesity. NIH consensus development conference, March 25-7,1991. Nutrition. 1996;12(6):397–404.
78. Burguera B, Agusti A, Arner P, Baltasar A, Barbe F, Barcelo A, Breton I, Cabanes T, Casanueva JF, Couce JE, Dieguez C, et al. Critical assessment of the current guidelines for the management and treatment of morbidly obese patients. J Endocrinol Invest. 2007;30(10):844–52. doi: 10.1007/bf03349226.
79. Bower G, Toma T, Harling L, Jiao LR, Efthimiou E, Darzi A, Athanasiou T, Ashrafian H. Bariatric Surgery and Non-Alcoholic Fatty Liver Disease: a Systematic Review of Liver Biochemistry and Histology. Obes Surg. 2015;25(12):2280–9. doi: 10.1007/s11695-015-1691-x.
80. Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition. 2009; 25(11–12): 1150–6. doi: 10.1016/j.nut.2009.03.012.
81. de Jonge C, Rensen SS, Koek GH, et al. Endoscopic duodenal-jejunal bypass liner rapidly improves plasma parameters of nonalcoholic fatty liver disease. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2013; 11(11): 1517–20. doi: 10.1016/j.cgh.2013.07.029 [published Online First: Epub Date]
82. Ricci G, Bersani G, Rossi A, Pigo F, De Fabritiis G, Alvisi V. Bariatric therapy with intragastric balloon improves liver dysfunction and insulin resistance in obese patients. Obesity surgery. 2008; 18(11): 1438–42. doi: 10.1007/s11695-008-9487-x[published Online First: Epub Date].
83. Lee YM, Low HC, Lim LG, et al. Intragastric balloon significantly improves nonalcoholic fatty liver disease activity score in obese patients with nonalcoholic steatohepatitis: a pilot study. Gastrointestinal endoscopy. 2012; 76(4): 756–60. doi: 10.1016/j.gie.2012.05.023[published Online First: Epub Date].
84. Corey K. E & Rinella M. E. Medical and Surgical Treatment Options for Nonalcoholic Steatohepatitis. Digestive diseases and sciences, 2016. 61(5): 1387–1397. https://doi.org/10.1007/s10620-016-4083-8.
85. Bazerbachi F, Vargas E. J, Rizk M Maselli D. B, Mounajjed T, Venkatesh S. K, Watt K. D, Port J. D, Basu R, Acosta A, Hanouneh I, Gara N, Shah M, Mundi M, Clark M, Grothe K, Storm A. C, Levy M. J, & Abu Dayyeh B. K. Intragastric Balloon Placement Induces Significant Metabolic and Histologic Improvement in Patients With Nonalcoholic Steatohepatitis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. 19(1), 146–154.e4. https://doi.org/10.1016/j.cgh.2020.04.068
86. Bazerbachi F, Vargas E. J, Rizk M, Maselli D. B, Mounajjed T, Venkatesh S. K, Watt K. D, Port J. D, Basu R, Acosta, Hanouneh I, Gara N, Shah M, Mundi M, Clark M, Grothe K, Storm A. C, Levy M. J & Abu Dayyeh, B. K.. Intragastric Balloon Placement Induces Significant Metabolic and Histologic Improvement in Patients With Nonalcoholic Steatohepatitis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. 19(1), 146–154.e4. https://doi.org/10.1016/j.cgh.2020.04.068
87. Roehlen N, Laubner K, Nicolaus L, Schwacha H, Bettinger D, Krebs A, Thimme R & Seufert, J.. Impact of duodenal-jejunal bypass liner (DJBL) on NAFLD in patients with obesity and type 2 diabetes mellitus. Nutrition (Burbank, Los Angeles County, Calif.). 2022: 103-104, 111806. https://doi.org/10.1016/j.nut.2022.111806
Published
15/12/2023
Statistics
727 Views | 301 Downloads
Citatons
How to Cite
Pratap, V. B., S. Amarthaluri, and R. Patil. “Various Treatment Modalities of Nafld: A Systematic Review”. International Journal of Alternative and Complementary Medicine, Vol. 4, no. 2, Dec. 2023, pp. 25-33, doi:10.46797/ijacm.v4i2.497.
Issue
Section
Review Article
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright © Author(s) retain the copyright of this article.
.