Non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease
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DOI：
10.7861/clinmedicine.18-3-245
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发表时间：
2018-06-01
影响因子：
4.4
通讯作者：
Manousou, Pinelopi
中科院分区：
文献类型：
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作者：
Maurice, James;Manousou, Pinelopi
非酒精性脂肪肝 (NAFLD) 的全球患病率约为 25%。随着肥胖、2 型糖尿病和代谢综合征水平的上升，NAFLD 的发病率也在增加，预计 NAFLD 将成为未来十年需要肝移植的肝硬化的主要原因。然而，心血管疾病是最常见的死亡原因，只有少数会出现纤维化和肝脏相关并发症。因此，必须使用非侵入性纤维化标志物来识别晚期疾病患者，其中包括基于血清学的测试（例如NAFLD纤维化评分和ELF测试）和成像（例如瞬时弹性成像）。该计划针对的是适合转诊至二级医疗机构进行额外检查的患者，例如肝活检和专科护理。改变生活方式和减肥仍然是治疗的基石，但我们即将进入 NASH 和纤维化药物治疗的新时代。
Non-alcoholic fatty liver disease (NAFLD) has a global prevalence of about 25%. Incidence is increasing with rising levels of obesity, type 2 diabetes and the metabolic syndrome, and NAFLD is predicted to become the leading cause of cirrhosis requiring liver transplantation in the next decade. However, the cardiovascular disease is the most common cause of death and only a minority will develop fibrosis and liver-related complications. Therefore, it is imperative to identify patients with advanced disease using non-invasive markers of fibrosis, which include serology-based tests (eg NAFLD Fibrosis Score and ELF test) and imaging (eg transient elastography). This targets appropriate patients for referral to secondary care for additional investigations such as liver biopsy and specialist care. Lifestyle modification and weight loss remains the cornerstone of management, but we are about to enter a new era of promising pharmacotherapies for NASH and fibrosis.