Nonalcoholic fatty liver disease
Nonalcoholic fatty liver disease
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DOI：
10.1053/gast.2002.33573
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发表时间：
2002-05-01
期刊：
影响因子：
29.4
通讯作者：
Diehl, AM
中科院分区：
文献类型：
--
作者：
Clark, JM;Brancati, FL;Diehl, AM
酒精引起的肝脏疾病，但在不酗酒的人中发展。在许多国家，NAFLD可能是慢性肝病的最常见原因，也可能加剧其他药物（如酒精、工业毒素和嗜肝病毒）引起的肝损伤。缺乏特异性和敏感性的非侵入性NAFLD检测限制了该疾病的可靠检测。通常，当影像学研究提示肝脂肪变性或当在超重或肥胖个体中注意到肝酶升高而没有其他可识别的肝病原因时，NAFLD被推定诊断。NAFLD与胰岛素抵抗和血脂异常密切相关;然而，它是否是这些其他疾病的原因或后果尚不清楚。NAFLD的自然史也不确定。然而，NAFLD在人群中的明显高患病率与临床显著肝病的普遍低患病率之间的差异，以及NAFLD患者在肝移植人群中的相对低代表性，已经对NAFLD的临床重要性产生了相当大的怀疑。后者降低了对NAFLD患者积极诊断、治疗和随访的热情。这篇关于NAFLD的临床文献和选定的基本信息的综述挑战了其中的一些假设。
cohol-induced liver disease but develops in individuals who are not heavy drinkers. NAFLD is likely to be the most common cause of chronic liver disease in many countries and may also potentiate liver damage induced by other agents, such as alcohol, industrial toxins, and hepatotrophic viruses. The lack of specific and sensitive noninvasive tests for NAFLD limit reliable detection of the disease. Often, NAFLD is diagnosed presumptively when imaging studies suggest hepatic steatosis or when liver enzyme elevations are noted in overweight or obese individuals with no other identifiable reason for liver disease. NAFLD is strongly associated with insulin resistance and dyslipidemia; however, whether it is a cause or a consequence of these other conditions in not clear. The natural history of NAFLD is also uncertain. Nevertheless, discrepancies between the apparently high prevalence of NAFLD in the population and the generally low prevalence of clinically significant liver disease, as well as the relatively low representation of NAFLD patients among liver transplant populations, have generated considerable skepticism about the clinical importance of NAFLD. The latter has reduced enthusiasm for aggressive diagnosis, treatment, and follow-up of patients with NAFLD. This review of the clinical literature and selected basic information about NAFLD challenges some of these assumptions.