Current status of liver disease in Korea: nonalcoholic fatty liver disease.
Current status of liver disease in Korea: nonalcoholic fatty liver disease.
复制标题
DOI：
10.3350/kjhep.2009.15.s6.s34
复制
发表时间：
2009-12-01
期刊：
影响因子：
--
通讯作者：
Park, Sang Hoon
中科院分区：
文献类型：
--
作者：
Park, Sang Hoon
最近，肥胖症（BMI>或=25 kg/m2）和II型糖尿病在韩国已达到流行比例，并且非酒精性脂肪性肝病（NAFLD）的发病率在一般人群的10%至25%之间。在韩国，NAFLD与代谢综合征的几个组成部分密切相关，包括肥胖、高血压、糖尿病和血脂异常，就像在西方国家一样。胰岛素抵抗和高胰岛素血症可能在正常体重和肥胖患者脂肪肝的发病机制中起作用。而且，肥胖诱导的脂肪在脂肪组织中的积累导致脂肪因子调节的失衡，例如脂联素的下调和视黄醇结合蛋白4（RBP 4）和生长素释放肽的上调。韩国患者的高BMI、AST/ALT比值和ALT水平可用于区分NASH和单纯性脂肪变性。在接受自愿体检的大量NAFLD患者中，即使是轻微的体重减轻也与超声检查的肝脂肪变性分级、血清转氨酶水平和相关代谢异常的改善相关。应建议脂肪肝受试者通过改变生活方式减肥。在韩国文献中已经报道了用PPAR激动剂和甜菜碱治疗的小动物和人类研究。现在公认NAFLD是韩国最常见的肝脏疾病，主要是由于肥胖和糖尿病等代谢异常的大量增加。未来的研究应继续关注NAFLD的发病机制和治疗，以积累更多的数据。
Recently, obesity (BMI>or=25 kg/m2) and type II diabetes mellitus have reached epidemic proportions in Korea, and rates of nonalcoholic fatty liver disease (NAFLD) are between 10% and 25% of the general population. NAFLD in Korea is as closely associated with several components of metabolic syndrome including, obesity, hypertension, diabetes and dyslipidemia as it is in Western countries. Insulin resistance and hyperinsulinemia may play a role in the pathogenesis of fatty liver in patients with normal body weight as well as in patients with obesity. And, obesity induced accumulation of fat in the adipose tissue leads to an imbalance in the regulation of adipokines, such as downregulation of adiponectin and upregulation of retinol-binding protein 4 (RBP4) and ghrelin. High BMI, the AST/ALT ratio, and ALT levels could be used to distinguish NASH from simple steatosis in Korean patients. In large number of NAFLD patients who underwent a voluntary medical checkup, even a small weight reduction was associated with improvements in their hepatic steatosis grade on ultrasonography, serum aminotransferase levels, and related metabolic abnormalities. Subjects with fatty liver disease should be advised to lose weight through lifestyle modifications. Small animal and human studies of treatment with PPAR agonists and betaine have been reported in the Korean literature. It is now acknowledged that NAFLD is the most common liver disease in Korea, largely due to the considerable increase in metabolic abnormalities such as obesity and diabetes. Future studies should continue to focus both on the pathogenesis and the treatment of NAFLD in order to accumulate more of our own data.