Multistep approach for treatment of non-alcoholic fatty liver disease – the impact of diet and pioglitazone

Aims: Non-alcoholic fatty liver disease (NAFLD) has a wide spectrum, potentially progressing to steatohepatitis, cirrhosis, and hepatocellular cancer. The metabolic syndrome is present in most cases of NAFLD. Methods: We included patients with elevation of at least 2 liver enzymes (ALAT or ASAT and g-GT) >1.5x UNL. All had liver biopsy and aminopyrine breath testing at baseline. They were subject to undergo a six months intervention period receiving a calory-reduced diet (aiming at max. 1200 Kcal/d) and lifestyle modification. In addition, if necessary, all had to limit their alcohol consumption to 40g/week. If…