ما هو علاج الخط الأول لمرض الكبد الدهني المرتبط بالخلل الوظيفي الأيضي؟

References

DOI: 10.1097/HEP.0000000000000323

• A healthy diet and regular exercise form the foundation of treatment for the vast majority of those with NAFLD.
• Patients with NAFLD who are overweight or obese should be prescribed a diet that leads to a caloric deficit. When possible, diets with limited carbohydrates and saturated fat and enriched with high fiber and unsaturated fats (e.g., Mediterranean diet) should be encouraged due to their additional cardiovascular benefits.
• Patients with NAFLD should be strongly encouraged to increase their activity level to the extent possible. Individualized prescriptive exercise recommendations may increase sustainability and have benefits independent of weight loss.
• Some studies demonstrate that regular moderate exercise at least 5 times per week for a total of 150 minutes per week or an increase in activity level by more than 60 minutes per week can prevent or improve NAFLD.
• Drinking 3 or more cups per day could be recommended in the absence of contraindications based on the reduced risk for NAFLD and liver fibrosis demonstrated in epidemiological studies and meta-analyses.
• Patients with clinically significant hepatic fibrosis (≥F2) should abstain from alcohol use completely.
• Weight loss of 3%–5% improves steatosis, but greater weight loss (>10%) is generally required to improve NASH and fibrosis.