NAFLD Clinical Trial
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver dysfunction
worldwide. NAFLD may progress to nonalcoholic steatohepatitis (NASH) and in turn to
cirrhosis. To date, the detailed pathogenic mechanism of NAFLD including steatosis and NASH
is not fully characterized, although it is regarded as a hepatic manifestation of the
metabolic syndrome, sometimes it occurs in the absence of a metabolic syndrome. Based on
conventional models of "two-hit" and "multi- hit" hypothesis of NAFLD, the dysregulated
lipid metabolism and insulin resistance are considered as the "first hit" of the liver and
the following "second hit" or "multi-hit" likely involves oxidative stress, lipid
peroxidation, increased inflammatory responses, induced hepatic fibrosis and apoptosis. This
emphasizes the multi-factorial pathogenesis of NAFLD and the necessity to treat NAFLD with
diabetes-like and multimodal strategy. Several changes in dietary intake have occurred in
the past few years, including increased energy intake (24%), and increases in added sugars,
flour and cereal products, fruit, added fats and total fat intake. The increasing prevalence
of NAFLD is probably directly affected by the contemporary epidemics of obesity, unhealthy
dietary pattern, and sedentary lifestyle. Currently, there are two major categories of NAFLD
therapy: lifestyle interventions and pharmaceutical therapies, lifestyle interventions in
terms of diet and physical activity are regarded as safe and effective, while pharmaceutical
interventions showed limited efficacy with unknown safety in the long term ,therefore, the
first line of treatment is lifestyle modification. Although lifestyle intervention dose
positively affects NAFLD, it has limitations. Patients adherence to dietary intervention is
50%, while those who do adhere, find it difficult to maintain after 12 months. ).
Mediterranean diet has been shown to be effective in reducing NAFLD, liver steatosis and
improve insulin sensitivity. Acupuncture has been found as an effective treatment for
improving quality of life in various medical conditions , including hepatitis . Acupuncture
combined with life style intervention has been found effective in the treatment of obesity,
metabolic syndrome in terms of weight, lipid regulation, glucose levels and various markers
of inflammation. Acupuncture's effect on NAFLD has yet to be studied.
We suggest that acupuncture combined with life style intervention can be an effective
treatment for NAFLD.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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