Recent advances in nonalcholic fatty liver disease
Recent advances in nonalcholic fatty liver disease
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DOI：
10.1097/mog.0b013e3282fbccf2
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发表时间：
2008-05-01
影响因子：
2.5
通讯作者：
Sanyal, Arun J.
中科院分区：
文献类型：
--
作者：
Greenfield, Victoria;Cheung, Onpan;Sanyal, Arun J.
目的reviewThe的目的是总结最近的进展，在定义的临床特征，病理生理学，自然史，和治疗nonalcoholic fatty liver disease.Recent findingsNonalcoholic fatty liver disease是目前在大约30%的美国人口。组织学分级和分期系统已经开发和验证。非酒精性脂肪肝会增加患代谢综合征的风险。非酒精性脂肪肝的存在和严重程度与肥胖的严重程度、脂肪分布、年龄和代谢综合征的其他特征的存在相关。15%至20%的非酒精性脂肪性肝炎受试者发展为肝硬化。肝脏脂肪变性与向肝脏输送用于再酯化的游离脂肪酸的增加和从头脂肪生成的增加有关。肝细胞损伤和死亡的几种机制包括游离脂肪酸毒性、游离胆固醇增加、细胞因子介导的损伤和未折叠蛋白反应的激活。虽然已经确定了许多治疗靶点并进行了试点研究，但非酒精性脂肪性肝炎的明确治疗仍有待建立。SummaryNonalcoholic fatty liver disease是一种广泛流行的疾病，与胰岛素抵抗和代谢综合征密切相关。虽然非酒精性脂肪性肝炎的发病机制和自然史有很多新的信息，但有效的治疗方法仍有待建立。
Purpose of reviewThe purpose of this review is to summarize recent advances in defining the clinical features, pathophysiology, natural history, and treatment of nonalcoholic fatty liver disease.Recent findingsNonalcoholic fatty liver disease is present in approximately 30% of the US population. A histologic grading and staging system has been developed and validated. Nonalcoholic fatty liver disease increases the risk of developing the metabolic syndrome. The presence and severity of nonalcoholic fatty liver disease correlates with the severity of obesity, fat distribution, age, and presence of other features of the metabolic syndrome. Fifteen to 20% of subjects with nonalcoholic steatohepatitis develop cirrhosis. Hepatic steatosis is associated with an increase in both free fatty acid delivery to the liver for re-esterification and increased de-novo lipogenesis. Several mechanisms of hepatocyte injury and death including free fatty acid toxicity, increased free cholesterol, cytokinemediated injury and activation of the unfolded protein response have been defined. While many therapeutic targets have been identified and pilot studies performed, a definitive treatment for nonalcoholic steatohepatitis remains to be established.SummaryNonalcoholic fatty liver disease is a widely prevalent disease that is critically linked to insulin resistance and the metabolic syndrome. While much new information on the pathogenesis and natural history of nonalcoholic steatohepatitis is available, an effective therapy remains to be established.