Nonalcoholic fatty liver disease and steatohepatitis are the most common
chronic diseases of the liver. The process of their development has not yet been fully
elucidated. It is characterized by insulin resistance, hepatic lipid accumulation with a
secondary pathologic production of free radicals that induce inflammatory processes
and fibrosis. There is no evidence-based therapy. It is important to eliminate the
pathogenic factors (excess body weight, disordered carbohydrate metabolism, and
hyperlipidemia). Potential modalities of a causal therapy include cannabinoid receptor
1 antagonists which do not cross the blood-brain barrier, cannabinoid receptor 2
agonists; selective serotonin 2C receptor agonist, thiazolidinediones, incretins, and
dipeptidyl peptidase inhibitors. Additional therapeutic possibilities of the future may
target antioxidant defense, immune-mediated mechanisms, apoptosis, and lipogenesis.
Keywords: Diabetes mellitus, Dipeptidyl peptidase inhibitors, Hyperlipidemia,
Incretins, Insulin resistance, Lifestyle modification, Nonalcoholic steatohepatitis,
Nonalcoholic steatosis, Thiazolidinediones, Treatment, Vitamin E, Weight loss.
