Non-alcoholic fatty liver disease: a current challenge of interdisciplinary research

This article describes the urgency of the issue of non-alcoholic fatty liver disease (NAFLD), a widespread chronic liver disease that physicians in different specialties have to deal with. Due to the rising prevalence of obesity, metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM) the number of patients with NAFLD has increased significantly. A new definition proposed by an international expert consensus statement – a metabolic dysfunction-associated fatty liver disease (MAFLD) is discussed. We also paid attention to the epidemiology of NAFLD and NAFLD-associated comorbidity. The role of insulin resistance (IR) in the development of the disease is described. NAFLD is characterized by a long-term asymptomatic course that can lead to irreversible liver injury. The importance of timely diagnosis of the disease is stressed. In most cases, hepatic steatosis is completely reversible if the causes leading to the development of the disease are eliminated. Advanced approaches to the treatment of non-alcoholic liver disease are discussed. Weight loss and regular physical activity are an integral part of successful treatment of NAFLD. Worthy of separate attention are essential phospholipids (EPL), which mechanisms of hepatoprotective action are disclosed, and the results of clinical studies on the efficacy of EPL are presented. Essential phospholipids are included in the standards and clinical guidelines for the treatment of NAFLD and other liver diseases and can be recommended to patients with NAFLD and concomitant cardiovascular and metabolic pathologies (obesity, arterial hypertension, T2DM, dyslipidemia). To achieve the discussed hepatoprotective effects of EPL in the NAFLD treatment practice, it is necessary to take into account that the course of administration of EPL (content of > 70%) in clinical studies was 3–6 months at a dose of 1800 mg per day (600 mg 3 times a day).