Pediatric non alcoholic fatty liver disease: old and new concepts on development, progression, metabolic insight and potential treatment targets.
Pediatric non alcoholic fatty liver disease: old and new concepts on development, progression, metabolic insight and potential treatment targets.
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DOI：
10.1186/1471-2431-13-40
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发表时间：
2013-03-25
期刊：
影响因子：
2.4
通讯作者：
Nobili V
中科院分区：
文献类型：
--
作者：
Giorgio V;Prono F;Graziano F;Nobili V
非酒精性脂肪性肝病（NAFLD）是儿童慢性肝病的主要原因。NAFLD已经变得非常普遍，并与肥胖和男性性别有关。在没有其他肝脏病理原因的情况下，肝脂肪浸润约占肝细胞的5%。它包括一系列疾病，从肝内脂肪堆积（脂肪变性）到不同程度的坏死性炎症和纤维化（非酒精性脂肪性肝炎[NASH]）。无论是儿童还是成人，NAFLD都与严重的代谢障碍有关，这决定了发生代谢综合征的风险增加。它可以发展为肝硬化和肝细胞癌，因此需要肝移植。遗传和环境因素似乎都参与了该病的发生和发展，但其生理病理机制尚不完全清楚。鉴于这一日益严重的涉及年轻人的流行病现象，NAFLD的研究应成为所有卫生保健系统的优先事项。本文综述了当前和新的儿科NAFLD临床组织学概念，并从病理生理和治疗角度探讨了可能的影响。
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in children. NAFLD has emerged to be extremely prevalent, and predicted by obesity and male gender. It is defined by hepatic fat infiltration >5% hepatocytes, in the absence of other causes of liver pathology. It includes a spectrum of disease ranging from intrahepatic fat accumulation (steatosis) to various degrees of necrotic inflammation and fibrosis (non-alcoholic steatohepatatis [NASH]). NAFLD is associated, in children as in adults, with severe metabolic impairments, determining an increased risk of developing the metabolic syndrome. It can evolve to cirrhosis and hepatocellular carcinoma, with the consequent need for liver transplantation. Both genetic and environmental factors seem to be involved in the development and progression of the disease, but its physiopathology is not yet entirely clear. In view of this mounting epidemic phenomenon involving the youth, the study of NAFLD should be a priority for all health care systems. This review provides an overview of current and new clinical-histological concepts of pediatric NAFLD, going through possible implications into patho-physiolocical and therapeutic perspectives.
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