Nonalcoholic Fatty Liver Disease 2020: The State of the Disease
Nonalcoholic Fatty Liver Disease 2020: The State of the Disease
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DOI：
10.1053/j.gastro.2020.01.052
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发表时间：
2020-05-01
期刊：
影响因子：
29.4
通讯作者：
Rinella, Mary
中科院分区：
文献类型：
--
作者：
Cotter, Thomas G.;Rinella, Mary
非酒精性脂肪性肝病（NAFLD）是最常见的肝病，全球患病率为25%。在美国，NAFLD及其亚型非酒精性脂肪性肝炎分别影响30%和5%的人口。考虑到从儿童开始的持续肥胖流行、糖尿病的增加和其他因素，NAFLD的患病率沿着晚期肝病患者的比例预计将继续增加。这将对公共卫生产生重要影响，反映在医疗保健费用上，包括对肝移植需求的影响，非酒精性脂肪性肝炎已经接近成为肝移植的最常见适应症。有非酒精性脂肪性肝炎和晚期纤维化证据的NAFLD患者不良结局的风险显著增加，包括总死亡率和肝脏特异性发病率和死亡率。考虑到相关的较差结局，确定NAFLD患者队列至关重要，以便将资源用于最需要的患者。在这方面已经开发了各种非侵入性工具。本文综述了NAFLD的流行病学、临床和预后特征以及诊断方法。
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease, with a worldwide prevalence of 25%. In the United States, NAFLD and its subtype, nonalcoholic steatohepatitis, affect 30% and 5% of the population, respectively. Considering the ongoing obesity epidemic beginning in childhood, the rise in diabetes, and other factors, the prevalence of NAFLD along with the proportion of those with advanced liver disease is projected to continue to increase. This will have an important impact on public health reflected in health care costs, including impact on the need for liver transplantation, for which nonalcoholic steatohepatitis is already close to becoming the most common indication. NAFLD patients with evidence of nonalcoholic steatohepatitis and advanced fibrosis are at markedly increased risk of adverse outcomes, including overall mortality, and liver-specific morbidity and mortality, respectively. Identification of this cohort of NAFLD patients is paramount, given the associated poorer outcomes, in order to target resources to those who need it most. Various noninvasive tools have been developed in this regard. This review provides an update on the epidemiology, clinical and prognostic features, and diagnostic approach to patients with NAFLD.