The increasing epidemic of obesity worldwide is linked to serious health effects, including increased prevalence of type 2 diabetes mellitus, cardiovascular disease and nonalcoholic fatty liver disease (NAFLD). It is estimated that 25% of the global adult population is potentially affected by NAFLD. NAFLD can be subdivided into non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH).
Nonalcoholic steatohepatitis (NASH) is the fastest growing liver disease and there is an urgent need for medical therapy for patients with NASH. (espace) NASH is characterized by hepatic steatosis ≥5%, inflammation and ballooned hepatocytes, with or without the presence of hepatic fibrosis.
In the United States alone, approximately 25% of NAFLD patients have NASH, NASH covers a wide spectrum of disease severity in individuals without significant alcohol consumption and without other causes of secondary steatosis. NASH can progress to cirrhosis, liver failure and, more rarely, hepatocellular carcinoma (HCC). By the end of 2020, NASH is expected to be the leading cause of liver transplantation in the United States.
One of the most promising therapeutic option focuses on peroxisome proliferator-activated receptors (PPARs). They regulate metabolism, inflammation and fibrosis, all of which determine NASH progression.