Nonalcoholic Fatty Liver Disease: Pathophysiology and Management.
Nonalcoholic Fatty Liver Disease: Pathophysiology and Management.
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DOI：
10.1016/j.gtc.2016.07.003
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发表时间：
2016-12
影响因子：
3.7
通讯作者：
Khungar V
中科院分区：
文献类型：
--
作者：
Carr RM;Oranu A;Khungar V
NAFLD是世界范围内发病率和死亡率的重要原因，这既因为心血管、肝脏和肿瘤后遗症，也因为它正迅速成为终末期肝病和肝移植的主要原因。在美国的患病率为30%，已经达到了流行病的程度。虽然代谢综合征是一种常见的风险因素，但在种族和民族群体之间存在差异，表明激素，营养和遗传因素之间的复杂相互作用在疾病发病机制中起作用。NAFLD的临床综合征从温和的脂肪变性到脂肪性肝炎，脂肪性肝炎可进展为纤维化和肝硬化。发病机制包括激素，营养和肠道生态失调，胰岛素抵抗，脂毒性，肝脏炎症和基因的作用进行了检查。非侵入性检测和肝活检指征进行审查。NAFLD和NASH的批准和研究治疗概述在这篇综述中，这是目前肝病学界非常感兴趣的一个领域。
NAFLD is an important cause of morbidity and mortality worldwide both because of cardiovascular, hepatic and oncologic sequelae as well as because it is rapidly becoming the leading cause of end stage liver disease and liver transplant. With a prevalence of 30% in the US, it has reached epidemic proportions. While the metabolic syndrome is a common risk factor, there are differences among racial and ethnic groups, suggesting the complex interaction between hormonal, nutritional and genetic factors at play in disease pathogenesis. The clinical syndrome of NAFLD spans from bland steatosis to steatohepatitis which can progress to fibrosis and cirrhosis. The pathogenesis including roles of hormones, nutritional and intestinal dysbiosis, insulin resistance, lipotoxicity, and hepatic inflammation, and genes are examined. Non-invasive testing and liver biopsy indications are reviewed. Approved and investigational therapies for NAFLD and NASH are outlined in this review of a disease that is currently an area of great interest to the hepatology community.
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