Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis.
Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis.
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DOI：
10.3748/wjg.v24.i30.3361
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发表时间：
2018-08-14
影响因子：
4.3
通讯作者：
Bolondi L
中科院分区：
文献类型：
--
作者：
Leoni S;Tovoli F;Napoli L;Serio I;Ferri S;Bolondi L
当前非酒精性脂肪肝病（NAFLD）的流行正在重塑全世界的肝病学领域。肥胖、2型糖尿病和血脂异常等代谢危险因素的广泛传播导致了 NAFLD 在世界范围内的传播。随着有效抗病毒药物的可用性不断增加，NAFLD 正迅速成为西方国家慢性肝病的最常见原因，预计未来几年东方国家也会出现类似的趋势。这种流行病及其后果促使世界各地的专家寻找诊断、管理和治疗 NAFLD 的有效策略。来自欧洲、美洲和亚太地区的不同科学协会根据有关 NAFLD 的最新证据提出了指导方针。这些指南与 NAFLD 管理的关键要素一致，但在一些关键点上仍然存在显着差异。我们回顾了当前的英文文献，以确定有关 NAFLD 的最新科学指南，旨在发现并批判性地分析主要差异。我们区分了来自 5 个不同科学协会的指南，这些协会的声誉得到全球认可，并且代表了不同地理区域的临床实践。差异体现在：NAFLD 的定义、高危患者中 NAFLD 筛查的机会、用于诊断 NAFLD 的非侵入性检测和晚期纤维化 NAFLD 患者的识别、后续方案以及最后的治疗策略（特别是提议的药物管理）。这些差异已根据未来几年 NAFLD 情况可能的演变进行了讨论。
The current epidemic of non-alcoholic fatty liver disease (NAFLD) is reshaping the field of hepatology all around the world. The widespread diffusion of metabolic risk factors such as obesity, type2-diabetes mellitus, and dyslipidemia has led to a worldwide diffusion of NAFLD. In parallel to the increased availability of effective anti-viral agents, NAFLD is rapidly becoming the most common cause of chronic liver disease in Western Countries, and a similar trend is expected in Eastern Countries in the next years. This epidemic and its consequences have prompted experts from all over the word in identifying effective strategies for the diagnosis, management, and treatment of NAFLD. Different scientific societies from Europe, America, and Asia-Pacific regions have proposed guidelines based on the most recent evidence about NAFLD. These guidelines are consistent with the key elements in the management of NAFLD, but still, show significant difference about some critical points. We reviewed the current literature in English language to identify the most recent scientific guidelines about NAFLD with the aim to find and critically analyse the main differences. We distinguished guidelines from 5 different scientific societies whose reputation is worldwide recognised and who are representative of the clinical practice in different geographical regions. Differences were noted in: the definition of NAFLD, the opportunity of NAFLD screening in high-risk patients, the non-invasive test proposed for the diagnosis of NAFLD and the identification of NAFLD patients with advanced fibrosis, in the follow-up protocols and, finally, in the treatment strategy (especially in the proposed pharmacological management). These difference have been discussed in the light of the possible evolution of the scenario of NAFLD in the next years.
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影响因子：
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