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Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi

Yıl 2015, Cilt: 16 Sayı: 1, 67 - 76, 08.05.2015
https://doi.org/10.18229/ktd.66765

Öz

Non Alkolik Yağlı Karaciğer Hastalığı, en yaygın karaciğer hastalıklarından biridir. NAYKH, obezitenin dünya epidemisiyle paralel olarak artmaktadır. NAYKH, basit yağlanmadan steatohepatite, ileri fibroz ve siroza ilerleyebilir. Kanıtlar; insülin direnci, oksidatif stres ve genetik faktörlerlerin interaksiyonunu içeren çoklu mekanizmaların NAYKH’nın gelişimini başlattığını göstermektedir. Halen onaylanmış bir ilaç tedavisi olmamasına rağmen pek çok yaklaşımın faydalı olabileceği göz önünde bulundurulmalıdır. İnsülin duyarlaştırıcılar, antioksidanlar, antilipidemik ilaçlar ve antiinflamatuar ilaçların faydalı etkileri gösterilmiştir. Bu yazıda NAYKH’ nın mevcut tedavisi ve potansiyel yeni tedaviler üzerine odaklanılmıştır

Kaynakça

  • Sonsuz A. Nonalkolik karaciğer yağlanması. http:// www.ctf.edu.tr/stek/pdfs/58/5807.pdf 23.11.2007. Erişim
  • Jansen PL. Nonalcoholic steatohepatitis. Neth J Med 2004;62(7):217-24.
  • Durazzo M, Belci P, Collo A, Grisoglio E, Bo S. Focus on therapeutic strategies of nonalcoholic fatty liver disea- se. http://www.medscape.com/viewarticle/474880?s- rc=search Erişim 17.10.2012.
  • Dabhi A, Brahmbhatt K, Pandya T, Thorat P, Shah M. Nonalcoholic fatty liver disease. JIACM 2008;9(1):36- 41.
  • Hajiaghamohammadi A, Ziaee A, Oveisi S, Masroor H. Effects of metformin, pioglitazone, and silymarin treat- ment on non-alcoholic fatty liver disease: a randomized controlled pilot study. Hepatitis Monthly 2012;12(8):1- 6.
  • Lomonaco R, Chen J, Chen K. An endocrine perspective of nonalcoholic fatty liver disease. Ther Adv Endocrinol Metab 2011;2(5):211–4.
  • Ledinghen V, Vergniol J. Transient elastography for the diagnosis of liver fibrosis. Expert Rev Med Devices 2010;7(6):811-23.
  • Trappoliere M, Tuccillo C, Federico A, Di Leva A, Niosi M. The treatment of NAFLD. Eur Rev Med Pharmacol Sci 2005;9(5):299-304.
  • Clark J. Weight loss as a treatment for nonalcoholic fatty liver disease. J Clin Gastroenterol 2006;40(Sup 1):39-43.
  • Harrison S, Kadakia S, Lang K, Schenker S. Nonalcoholic steatohepatitis: what we know in the new millennium. Am J Gastroenterol. 2002 Nov;97(11):2714-24.
  • Vajro P, Lenta S, Pignata C et al. Therapeutic options in pediatric non alcoholic fatty liver disease: current status and future directions. http://www.ijponline.net/content/pdf/1824-7288- 38-55.pdf doi:10.1186/1824-7288-38-55 Erişim 12.10.2012
  • Sözen M, Türkay C. Ursodeoksikolik asit için tıbbi endi- kasyonlar ve etki mekanizmaları. http://guncel.tgv.org. tr/journal/39/pdf/100039.pdf Erişim 2011
  • Grigoreva I. Ursodeoxycholic acid in the treatment of nonalcoholic fatty liver disease. Eksp Klin Gastroente- rol 2011;(9):125-31.
  • Trauner M, Graziadei I. Rewiev article: Mechanism of action and therapeutic application of ursodeoxycholic acid in chronic liver disease. Aliment Pharmacol Ther 1999;13:979-96.
  • Kowdley K. Ursodeoxycholic acid therapy in hepatobili- ary disease. Am J Med 2000;108(6):481-6.
  • Lindor K, Kowdey K, Heathcote E et al. Ursodeoxycholic acid for treatment of nonalcoholic steatohepatitis: re- sult of a randomized trial. Hepatology 2004;39(3):770
  • Vajro P, Veropalumbo C. Citrin deficiency: learn more, and don’t forget to add it to list of neonatal cholestasis and the NASH trash bin. J Pediatr 2010;50(6):578-9.
  • Adams L, Angulo P, Petz J, Keach J, Lindor K. A pilot trial of high dose ursodeoxycholic acid in nonalcoholic steatohepatitis. Hepatol Int 2010;28(3):628-33.
  • Pietu F, Guillaud O, Walter T et al. Ursodeoxycholic acid with vitamin E in patients with nonalcoholic steatohe- patitis: long-term results. Clin Res Hepatol Gastroente- rol 2012;36(2):146-55.
  • Shyangdan D, Clar C, Ghouri N. Insulin sensitisers in the treatment of non-alcoholic fatty liver disease: a syste- matic review. Health Technol Assess 2011;15(38):1- 110.
  • Boettcher E, Csako G, Pucino F, Wesley R, Loomba R. Meta-analysis: pioglitazone improves liver histology and fibrosis in patients with non-alcoholic steatohepa- titis. Aliment Pharmacol Ther 2012;35(1):66-75.
  • Gastaldelli A, Harrison S, Belfort-Aguiar R et al. Piogli- tazone in the treatment of NASH: the role of adiponec- tin. Aliment Pharmacol Ther 2010;32(6):769-75.
  • Harmancı A, Gürlek A. Eski ilaç, eski ve yeni kullanım- ları: Metformin. http://ichastaliklaridergisi.org/manag- ete/fu_folder/2005-01/html/2005-12-1-029-037.htm Erişim 01.10.2012
  • Mazza A, Fruci B, Garinis GA, Giuliano S, Malaguarne- ra R, Belfiore A. The role of metformin in the manage- ment of NAFLD. Exp Diabetes Res 2012;2012:716404.
  • Akcam M, Boyaci A. Pirgon O et al. Therapeutic effect of metformin and vitamin E versus prescriptive diet in obese adolescents with fatty liver. Int J Vitam Nutr Res 2011;81(6):398-406.
  • Chatrath H, Vuppalanchi R, Chalasani N. Dyslipidemia in patients with nonalcoholic fatty liver disease. Semin Liver Dis 2012;32(1):22-9.
  • Dima A, Marinescu A, Dima AC. Nonalcoholic fatty liver disease and the statins treatment. Rom J Intern Med 2012 2012;50(1):19-25.
  • Nseir W. Mograbi J, Ghali M. Lipid-lowering agents in nonalcoholic fatty liver disease and steatohepatitis: human studies. Dig Dis Sci 2012;57(7):1773-81.
  • Tzefos M, Olin JL. 3-hydroxyl-3-methylglutaryl coenzy- me A reductase inhibitor use in chronic liver disease: a therapeutic controversy. J Clin Lipidol 2011;5(6):450-9.
  • Hyogo H, Yamagishi S, Maeda S et al. Atorvastatin im- proves disease activity of nonalcoholic steatohepatitis partly through its tumour necrosis factor-α-lowering property. Dig Liver Dis 2012;44(6):492-6.
  • Hyogo H, Tazuma S, Arihiro K et al. Efficacy of atorvas- tatin for the treatment of nonalcoholic steatohepatitis with dyslipidemia. Metabolism 2008;57(12):1711-8.
  • Onat A, Ceyhan K, Sansoy V ve ark. Erişkinlerimizin ya- rısında bulunan dislipidemi ve metabolik sendromun özellikleri ve kombine hiperlipidemi ile ilişkisi; aynı za- manda plazma trigliserid düzeyi üst sınırı konusunda bir katkı. Arch Turk Soc Cardiol 2001;29(5):274-85.
  • Fernandez -Miranda C, Perez- Carreras M, Colina F et al. A pilot trial of fenofibrate for the treatment of non-alcoholic fatty liver disease. Dig Liver Dis. 2008 Mar;40(3):200-5.
  • Zambon A, Cusi K. The role of fenofibrate in clinical pra- ctice. Diab Vasc Dis Res 2007;4(Suppl 3):15-20.
  • Ohki T, Isogawa A, Iwamoto M et al. The effectiveness of liraglutide in nonalcoholic Fatty liver disease patients with type 2 diabetes mellitus compared to sitagliptin and pioglitazone. ScientificWorldJournal 2012;2012:496453.
  • Athyros VG, Giouleme O, Ganotakis ES et al. Safety and impact on cardiovascular events of long-term multifactorial treatment in patients with metabolic syndrome and abnormal liver function tests: a post hoc analysis of the randomised attempt study. Arch Med Sci 2011;7(5):796-9.
  • Süzer Ö. Santral Sinir Sistemi Situmulanları ve Psikoto- mimetik İlaçlar. http://www.ctf.edu.tr/farma/onersu- zer/pdf/tr/12_SSS_stimulanlari.pdf Erişim 3.10.2009
  • Abdelmalek MF, Angulo P, Jorgensen RA et al. Betaine, a promising new agent for patients with nonalcoholic steatohepatitis: results of a pilot study. Am J Gastroen- terol 2001;96(9):2711-7.
  • Miglio F, Rovati LC, Santoro A et al. Efficacy and safety of oral betaine glucuronate in non-alcoholic steato- hepatitis. A doubleblind, randomized, parallel-group, placebo-controlled prospective clinical study. Arznei- mittelforschung 2000;50(8):722–5.
  • Lavine JE. Vitamin E treatment of nonalcoholic ste- atohepatitis in children: a pilot study. J Pediatr 2000;136(6):734-8.
  • Harrison S, Torgerson S, Hayashi P et al. Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis. Am Gastroenterol 2003;98(11):2485–90.
  • Adams LA, Angulo P. Vitamins E and C for the treatment of NASH: duplication of results but lack of demonstrati- on of efficacy. Am J Gastroenterol 2003;98(11):2348–
  • Sanyal AJ, Contos MJ, Sargeant C. A randomized cont- rolled pilot study of pioglitazone and vitamin E versus vitamin E for nonalcoholic steatohepatitis. Hepatology 2002;36:A-382. 44. Khoshbaten M, Aliasgarzadeh A, Masnadi K et al. N-acetylcysteine improves liver fun- ction in patients with non-alcoholic Fatty liver disease. Hepat Mon 2010;10(1):12-6.
  • de Oliveira CP, Stefano JT, de Siqueira ER et al. Combina- tion of N-acetylcysteine and metformin improves histo- logical steatosis and fibrosis in patients with non-alco- holic steatohepatitis. Hepatol Res 2008;38(2):159-65.
  • Bektaş M, Özden A. Barsak florası, probiyotikler ve karaciğer hastalıklarında probiyotiklerin yeri. Güncel Gastroenteroloji. http://guncel.tgv.org.tr/journal/18/ pdf/203.pdf Erişim 01.06.2006
  • Li Z, Yang S, Lin H et al. Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease. Hepatology 2003;37: 343-50.
  • Loguercio C, Simone TD, Federico A et al. Gut-liver axis: a new point of attack to treat chronic liver damage? Am J Gastroenterol 2002;97:2144-6.
  • Minno M, Russolillo A, Lupoli R et al. Omega-3 fatty acids for the treatment of non-alcoholic fatty liver disease. World J Gastroenterol 2012;18(41):5839–47.
  • Alfin-Slater RB, Bernick S. Changes in tissue lipids and tissue histology resulting from essential fatty acid deficiency in rats. Am J Clin Nutr 1958;6(6):613–24.

Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi

Yıl 2015, Cilt: 16 Sayı: 1, 67 - 76, 08.05.2015
https://doi.org/10.18229/ktd.66765

Öz

Nonalcoholic fatty liver disease is one of the most prevalent liver disease. NAFLD is increasing in parallel with the worldwide epidemic of obesity. NAFLD may progress from simple steatosis to steatohepatitis, advanced fibrosis and cirrhosis. Several evidences suggest that multiple mechanisms including insulin resistance, oxidative stress, inflammation, and genetic factors interact to initiate the development of NAFLD. Despite that there is currently no approved drug therapy for NAFLD, many approaches consider to be beneficial. Insulin sensitizers, antioxidants, antilipidemic drugs and antiinflammatory agents showed promising effects. This paper is focused on the currently treatments for NAFLD

Kaynakça

  • Sonsuz A. Nonalkolik karaciğer yağlanması. http:// www.ctf.edu.tr/stek/pdfs/58/5807.pdf 23.11.2007. Erişim
  • Jansen PL. Nonalcoholic steatohepatitis. Neth J Med 2004;62(7):217-24.
  • Durazzo M, Belci P, Collo A, Grisoglio E, Bo S. Focus on therapeutic strategies of nonalcoholic fatty liver disea- se. http://www.medscape.com/viewarticle/474880?s- rc=search Erişim 17.10.2012.
  • Dabhi A, Brahmbhatt K, Pandya T, Thorat P, Shah M. Nonalcoholic fatty liver disease. JIACM 2008;9(1):36- 41.
  • Hajiaghamohammadi A, Ziaee A, Oveisi S, Masroor H. Effects of metformin, pioglitazone, and silymarin treat- ment on non-alcoholic fatty liver disease: a randomized controlled pilot study. Hepatitis Monthly 2012;12(8):1- 6.
  • Lomonaco R, Chen J, Chen K. An endocrine perspective of nonalcoholic fatty liver disease. Ther Adv Endocrinol Metab 2011;2(5):211–4.
  • Ledinghen V, Vergniol J. Transient elastography for the diagnosis of liver fibrosis. Expert Rev Med Devices 2010;7(6):811-23.
  • Trappoliere M, Tuccillo C, Federico A, Di Leva A, Niosi M. The treatment of NAFLD. Eur Rev Med Pharmacol Sci 2005;9(5):299-304.
  • Clark J. Weight loss as a treatment for nonalcoholic fatty liver disease. J Clin Gastroenterol 2006;40(Sup 1):39-43.
  • Harrison S, Kadakia S, Lang K, Schenker S. Nonalcoholic steatohepatitis: what we know in the new millennium. Am J Gastroenterol. 2002 Nov;97(11):2714-24.
  • Vajro P, Lenta S, Pignata C et al. Therapeutic options in pediatric non alcoholic fatty liver disease: current status and future directions. http://www.ijponline.net/content/pdf/1824-7288- 38-55.pdf doi:10.1186/1824-7288-38-55 Erişim 12.10.2012
  • Sözen M, Türkay C. Ursodeoksikolik asit için tıbbi endi- kasyonlar ve etki mekanizmaları. http://guncel.tgv.org. tr/journal/39/pdf/100039.pdf Erişim 2011
  • Grigoreva I. Ursodeoxycholic acid in the treatment of nonalcoholic fatty liver disease. Eksp Klin Gastroente- rol 2011;(9):125-31.
  • Trauner M, Graziadei I. Rewiev article: Mechanism of action and therapeutic application of ursodeoxycholic acid in chronic liver disease. Aliment Pharmacol Ther 1999;13:979-96.
  • Kowdley K. Ursodeoxycholic acid therapy in hepatobili- ary disease. Am J Med 2000;108(6):481-6.
  • Lindor K, Kowdey K, Heathcote E et al. Ursodeoxycholic acid for treatment of nonalcoholic steatohepatitis: re- sult of a randomized trial. Hepatology 2004;39(3):770
  • Vajro P, Veropalumbo C. Citrin deficiency: learn more, and don’t forget to add it to list of neonatal cholestasis and the NASH trash bin. J Pediatr 2010;50(6):578-9.
  • Adams L, Angulo P, Petz J, Keach J, Lindor K. A pilot trial of high dose ursodeoxycholic acid in nonalcoholic steatohepatitis. Hepatol Int 2010;28(3):628-33.
  • Pietu F, Guillaud O, Walter T et al. Ursodeoxycholic acid with vitamin E in patients with nonalcoholic steatohe- patitis: long-term results. Clin Res Hepatol Gastroente- rol 2012;36(2):146-55.
  • Shyangdan D, Clar C, Ghouri N. Insulin sensitisers in the treatment of non-alcoholic fatty liver disease: a syste- matic review. Health Technol Assess 2011;15(38):1- 110.
  • Boettcher E, Csako G, Pucino F, Wesley R, Loomba R. Meta-analysis: pioglitazone improves liver histology and fibrosis in patients with non-alcoholic steatohepa- titis. Aliment Pharmacol Ther 2012;35(1):66-75.
  • Gastaldelli A, Harrison S, Belfort-Aguiar R et al. Piogli- tazone in the treatment of NASH: the role of adiponec- tin. Aliment Pharmacol Ther 2010;32(6):769-75.
  • Harmancı A, Gürlek A. Eski ilaç, eski ve yeni kullanım- ları: Metformin. http://ichastaliklaridergisi.org/manag- ete/fu_folder/2005-01/html/2005-12-1-029-037.htm Erişim 01.10.2012
  • Mazza A, Fruci B, Garinis GA, Giuliano S, Malaguarne- ra R, Belfiore A. The role of metformin in the manage- ment of NAFLD. Exp Diabetes Res 2012;2012:716404.
  • Akcam M, Boyaci A. Pirgon O et al. Therapeutic effect of metformin and vitamin E versus prescriptive diet in obese adolescents with fatty liver. Int J Vitam Nutr Res 2011;81(6):398-406.
  • Chatrath H, Vuppalanchi R, Chalasani N. Dyslipidemia in patients with nonalcoholic fatty liver disease. Semin Liver Dis 2012;32(1):22-9.
  • Dima A, Marinescu A, Dima AC. Nonalcoholic fatty liver disease and the statins treatment. Rom J Intern Med 2012 2012;50(1):19-25.
  • Nseir W. Mograbi J, Ghali M. Lipid-lowering agents in nonalcoholic fatty liver disease and steatohepatitis: human studies. Dig Dis Sci 2012;57(7):1773-81.
  • Tzefos M, Olin JL. 3-hydroxyl-3-methylglutaryl coenzy- me A reductase inhibitor use in chronic liver disease: a therapeutic controversy. J Clin Lipidol 2011;5(6):450-9.
  • Hyogo H, Yamagishi S, Maeda S et al. Atorvastatin im- proves disease activity of nonalcoholic steatohepatitis partly through its tumour necrosis factor-α-lowering property. Dig Liver Dis 2012;44(6):492-6.
  • Hyogo H, Tazuma S, Arihiro K et al. Efficacy of atorvas- tatin for the treatment of nonalcoholic steatohepatitis with dyslipidemia. Metabolism 2008;57(12):1711-8.
  • Onat A, Ceyhan K, Sansoy V ve ark. Erişkinlerimizin ya- rısında bulunan dislipidemi ve metabolik sendromun özellikleri ve kombine hiperlipidemi ile ilişkisi; aynı za- manda plazma trigliserid düzeyi üst sınırı konusunda bir katkı. Arch Turk Soc Cardiol 2001;29(5):274-85.
  • Fernandez -Miranda C, Perez- Carreras M, Colina F et al. A pilot trial of fenofibrate for the treatment of non-alcoholic fatty liver disease. Dig Liver Dis. 2008 Mar;40(3):200-5.
  • Zambon A, Cusi K. The role of fenofibrate in clinical pra- ctice. Diab Vasc Dis Res 2007;4(Suppl 3):15-20.
  • Ohki T, Isogawa A, Iwamoto M et al. The effectiveness of liraglutide in nonalcoholic Fatty liver disease patients with type 2 diabetes mellitus compared to sitagliptin and pioglitazone. ScientificWorldJournal 2012;2012:496453.
  • Athyros VG, Giouleme O, Ganotakis ES et al. Safety and impact on cardiovascular events of long-term multifactorial treatment in patients with metabolic syndrome and abnormal liver function tests: a post hoc analysis of the randomised attempt study. Arch Med Sci 2011;7(5):796-9.
  • Süzer Ö. Santral Sinir Sistemi Situmulanları ve Psikoto- mimetik İlaçlar. http://www.ctf.edu.tr/farma/onersu- zer/pdf/tr/12_SSS_stimulanlari.pdf Erişim 3.10.2009
  • Abdelmalek MF, Angulo P, Jorgensen RA et al. Betaine, a promising new agent for patients with nonalcoholic steatohepatitis: results of a pilot study. Am J Gastroen- terol 2001;96(9):2711-7.
  • Miglio F, Rovati LC, Santoro A et al. Efficacy and safety of oral betaine glucuronate in non-alcoholic steato- hepatitis. A doubleblind, randomized, parallel-group, placebo-controlled prospective clinical study. Arznei- mittelforschung 2000;50(8):722–5.
  • Lavine JE. Vitamin E treatment of nonalcoholic ste- atohepatitis in children: a pilot study. J Pediatr 2000;136(6):734-8.
  • Harrison S, Torgerson S, Hayashi P et al. Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis. Am Gastroenterol 2003;98(11):2485–90.
  • Adams LA, Angulo P. Vitamins E and C for the treatment of NASH: duplication of results but lack of demonstrati- on of efficacy. Am J Gastroenterol 2003;98(11):2348–
  • Sanyal AJ, Contos MJ, Sargeant C. A randomized cont- rolled pilot study of pioglitazone and vitamin E versus vitamin E for nonalcoholic steatohepatitis. Hepatology 2002;36:A-382. 44. Khoshbaten M, Aliasgarzadeh A, Masnadi K et al. N-acetylcysteine improves liver fun- ction in patients with non-alcoholic Fatty liver disease. Hepat Mon 2010;10(1):12-6.
  • de Oliveira CP, Stefano JT, de Siqueira ER et al. Combina- tion of N-acetylcysteine and metformin improves histo- logical steatosis and fibrosis in patients with non-alco- holic steatohepatitis. Hepatol Res 2008;38(2):159-65.
  • Bektaş M, Özden A. Barsak florası, probiyotikler ve karaciğer hastalıklarında probiyotiklerin yeri. Güncel Gastroenteroloji. http://guncel.tgv.org.tr/journal/18/ pdf/203.pdf Erişim 01.06.2006
  • Li Z, Yang S, Lin H et al. Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease. Hepatology 2003;37: 343-50.
  • Loguercio C, Simone TD, Federico A et al. Gut-liver axis: a new point of attack to treat chronic liver damage? Am J Gastroenterol 2002;97:2144-6.
  • Minno M, Russolillo A, Lupoli R et al. Omega-3 fatty acids for the treatment of non-alcoholic fatty liver disease. World J Gastroenterol 2012;18(41):5839–47.
  • Alfin-Slater RB, Bernick S. Changes in tissue lipids and tissue histology resulting from essential fatty acid deficiency in rats. Am J Clin Nutr 1958;6(6):613–24.
Toplam 49 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Akif Acay Bu kişi benim

Yayımlanma Tarihi 8 Mayıs 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 16 Sayı: 1

Kaynak Göster

APA Acay, A. (2015). Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi. Kocatepe Tıp Dergisi, 16(1), 67-76. https://doi.org/10.18229/ktd.66765
AMA Acay A. Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi. KTD. Nisan 2015;16(1):67-76. doi:10.18229/ktd.66765
Chicago Acay, Akif. “Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi”. Kocatepe Tıp Dergisi 16, sy. 1 (Nisan 2015): 67-76. https://doi.org/10.18229/ktd.66765.
EndNote Acay A (01 Nisan 2015) Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi. Kocatepe Tıp Dergisi 16 1 67–76.
IEEE A. Acay, “Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi”, KTD, c. 16, sy. 1, ss. 67–76, 2015, doi: 10.18229/ktd.66765.
ISNAD Acay, Akif. “Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi”. Kocatepe Tıp Dergisi 16/1 (Nisan 2015), 67-76. https://doi.org/10.18229/ktd.66765.
JAMA Acay A. Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi. KTD. 2015;16:67–76.
MLA Acay, Akif. “Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi”. Kocatepe Tıp Dergisi, c. 16, sy. 1, 2015, ss. 67-76, doi:10.18229/ktd.66765.
Vancouver Acay A. Non Alkolik Yağlı Karaciğer Hastalığında Güncel Medikal Tedavi. KTD. 2015;16(1):67-76.

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