Epidemiology of Non-Alcoholic Fatty Liver Disease
Epidemiology of Non-Alcoholic Fatty Liver Disease
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DOI：
10.1159/000282080
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发表时间：
2010-01-01
影响因子：
2.3
通讯作者：
Bedogni, Giorgio
中科院分区：
文献类型：
--
作者：
Bellentani, Stefano;Scaglioni, Federica;Bedogni, Giorgio
非酒精性脂肪肝（NAFLD）正在迅速成为全球最常见的肝病。西方国家一般人群中NAFLD的患病率为20- 30%。据估计，一般人群中约有2-3%患有非酒精性脂肪性肝炎（NASH），其可能进展为肝硬化和肝癌。一般来说，NAFLD的患病率在男性中较高，并随着年龄的增长而增加，并且受诊断方法和人群特征，特别是生活习惯的影响。与尸检和临床研究相比，基于人群的研究提供了更好的NAFLD患病率估计，但迄今为止很少进行此类研究。在人群研究中，NAFLD的诊断通常是通过超声检查获得的，众所周知，超声检查低估了脂肪肝的患病率。达拉斯心脏研究和狄俄尼索斯研究报告称，美国30%的成年人和意大利25%的成年人患有NAFLD。在这些研究中，79%和55%的NAFLD患者转氨酶水平正常，表明肝酶不是一般人群中NAFLD的替代标志物。非侵入性标志物，如从Dionysos研究中获得的脂肪肝指数，可能有助于在一般人群中筛查NAFLD。NAFLD最重要的危险因素是男性、年龄、肥胖、胰岛素抵抗和定义代谢综合征的心脏代谢改变。NAFLD的患病率在肥胖成人中为80-90%，在糖尿病患者中为30-50%，在高脂血症患者中高达90%。NAFLD在儿童中的患病率为3- 10%，在肥胖儿童中高达40-70%。此外，儿童NAFLD从十年前的3%左右增加到今天的5%，男女比例为2：1。NAFLD的发病率和自然史仍然没有很好的定义，但公认的是，大多数NAFLD患者不会发展为NASH。NAFLD的发病率在西方国家可能正在增加，这与生活习惯密切相关。版权所有（C）2010 S. Karger AG，巴塞尔
Non-alcoholic fatty liver disease (NAFLD) is rapidly becoming the most common liver disease worldwide. The prevalence of NAFLD in the general population of Western countries is 20-30%. About 2-3% of the general population is estimated to have non-alcoholic steatohepatitis (NASH), which may progress to liver cirrhosis and hepatocarcinoma. As a rule, the prevalence of NAFLD is higher in males and increases with increasing age, and it is influenced by the diagnostic method and the characteristics of the population, especially lifestyle habits. Population-based studies provide better estimates of the prevalence of NAFLD as compared to autoptic and clinical studies, but few such studies have been performed to date. The diagnosis of NAFLD in population studies is usually obtained by ultrasonography, which is known to underestimate the prevalence of fatty liver. The Dallas Heart Study and the Dionysos Study reported that 30% of the adults in the USA and 25% in Italy have NAFLD. In these studies, 79% and 55% of patients with NAFLD had normal aminotransferase levels, showing that liver enzymes are not surrogate markers of NAFLD in the general population. Noninvasive markers such as the fatty liver index obtained from the Dionysos Study may be useful to screen for NAFLD in the general population. The most important risk factors for NAFLD are male gender, age, obesity, insulin resistance and the cardiometabolic alterations that define the metabolic syndrome. The prevalence of NAFLD is 80-90% in obese adults, 30-50% in patients with diabetes and up to 90% in patients with hyperlipidemia. The prevalence of NAFLD among children is 3-10%, rising up to 40-70% among obese children. Moreover, pediatric NAFLD increased from about 3% a decade ago to 5% today, with a male-to-female ratio of 2:1. The incidence and natural history of NAFLD are still not well defined, but it is recognized that the majority of individuals with NAFLD do not develop NASH. The incidence of NAFLD is probably increasing in Western countries, strictly linked to lifestyle habits. Copyright (C) 2010 S. Karger AG, Basel