Cardiovascular and Systemic Risk in Nonalcoholic Fatty Liver Disease - Atherosclerosis as a Major Player in the Natural Course of NAFLD
Cardiovascular and Systemic Risk in Nonalcoholic Fatty Liver Disease - Atherosclerosis as a Major Player in the Natural Course of NAFLD
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DOI：
10.2174/1381612811319290003
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发表时间：
2013-09-01
影响因子：
3.1
通讯作者：
Targher, Giovanni
中科院分区：
文献类型：
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作者：
Lonardo, Amedeo;Sookoian, Silvia;Targher, Giovanni
非酒精性脂肪性肝病（NAFLD）包括通过非酒精性脂肪性肝炎（NASH）的纯脂肪变性，并且是西方国家慢性肝病的最常见原因。NASH是一种进行性肝病，可增加肝硬化和终末期肝病的风险。有趣的是，NAFLD的全球健康风险并不局限于肝脏。与那些没有NAFLD的患者相比，NAFLD患者不仅表现出肝脏相关并发症和肝脏相关死亡率增加，而且发展为2型糖尿病，心血管疾病（CVD）和慢性肾脏疾病的风险增加，主要肝脏手术后术后并发症的风险增加，以及发展某些恶性肿瘤的风险增加，包括原发性肝癌和结直肠癌。在这篇综述中，我们讨论了目前NAFLD与CVD风险相关的证据，这些证据可能发生在NAFLD自然病程中的其他肝脏和肝外并发症的更复杂情况下。此外，我们提供了一个简单的描述，这些并发症的生物学机制，特别强调给予CVD。我们的结论是，NAFLD是一个复杂的健康问题，其影响远远超出肝脏。因此，它可能会造成重大的全球健康负担，并且NAFLD患者的援助会影响许多不同医学专业的医生的工作。
Non-alcoholic fatty liver disease (NAFLD) encompasses pure steatosis through nonalcoholic steatohepatitis (NASH) and is the most common cause of chronic liver disease in Western countries. NASH is a progressive liver disease that increases the risk of cirrhosis and end-stage liver disease. Interestingly, the global health risk of NAFLD is not confined to the liver. Compared with those without NAFLD, patients with NAFLD exhibit not only increased liver-related complications and liver-related mortality but also increased risk of developing type 2 diabetes, cardiovascular disease (CVD) and chronic kidney disease, increased risk of post-operative complications after major liver surgery, and increased risk of developing certain malignancies, including primary liver cancer and colorectal cancer. In this review, we discuss the current evidence linking NAFLD with the risk of CVD in the setting of the more complex scenario of other hepatic and extra-hepatic complications that may occur during the natural course of NAFLD. Moreover, we provide a brief description of the putative biological mechanisms underlying such complications, particular emphasis being given to CVD. We conclude that NAFLD is a complex health problem with implications far beyond the liver. Hence, it may cause a significant global health burden and the assistance of patients with NAFLD impacts on the work of physicians from many different medical specialties.