Nonalcoholic fatty liver disease and diabetes.
Nonalcoholic fatty liver disease and diabetes.
复制标题
非酒精性脂肪肝和糖尿病。
DOI：
10.4239/wjd.v13.i9.668
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发表时间：
2022-09-15
影响因子：
4.2
通讯作者：
D'Andrea V
中科院分区：
文献类型：
--
作者：
Bellini MI;Urciuoli I;Del Gaudio G;Polti G;Iannetti G;Gangitano E;Lori E;Lubrano C;Cantisani V;Sorrenti S;D'Andrea V
非酒精性脂肪性肝病（NAFLD）是世界上最普遍的慢性肝病，代表了一种临床组织病理学实体，其中脂肪变性成分的程度可能不同，可能有也可能没有纤维化进展。NAFLD发病机制的关键概念是由于游离脂肪酸流入和流出之间的不平衡而导致的甘油三酯过度肝脏蓄积。强有力的流行病学、生物化学和治疗证据支持这样的前提，即大多数NAFLD患者的主要病理生理紊乱是胰岛素抵抗;因此，糖尿病和NAFLD之间的关联在文献中得到广泛认可。由于NAFLD是代谢性疾病的肝脏表现，因此它也与较高的心血管风险相关。常规B超被广泛采用作为肝脂肪变性的一线成像方式，尽管磁共振成像代表了量化这些患者脂肪量的金标准非侵入性方式。NAFLD患者的治疗取决于疾病的严重程度，从非酒精性脂肪肝的良性疾病到非酒精性脂肪性肝炎。与所有糖尿病患者一样，建议NAFLD患者戒酒，地中海饮食和修改风险因素，以避免重大心血管事件。此外，减肥手术引起的体重减轻似乎也能有效改善肝脏功能，以及对糖尿病控制或解决、血脂异常和高血压的益处。最后，肝移植是严重非酒精性脂肪肝的最终治疗方法，在西方国家正迅速发展为主要适应症。这篇综述提供了一个全面的多学科方法来NAFLD，强调其与糖尿病的联系。
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in the world and represents a clinical-histopathologic entity where the steatosis component may vary in degree and may or may not have fibrotic progression. The key concept of NAFLD pathogenesis is excessive triglyceride hepatic accumulation because of an imbalance between free fatty acid influx and efflux. Strong epidemiological, biochemical, and therapeutic evidence supports the premise that the primary pathophysiological derangement in most patients with NAFLD is insulin resistance; thus the association between diabetes and NAFLD is widely recognized in the literature. Since NAFLD is the hepatic manifestation of a metabolic disease, it is also associated with a higher cardio-vascular risk. Conventional B-mode ultrasound is widely adopted as a first-line imaging modality for hepatic steatosis, although magnetic resonance imaging represents the gold standard noninvasive modality for quantifying the amount of fat in these patients. Treatment of NAFLD patients depends on the disease severity, ranging from a more benign condition of nonalcoholic fatty liver to nonalcoholic steatohepatitis. Abstinence from alcohol, a Mediterranean diet, and modification of risk factors are recommended for patients suffering from NAFLD to avoid major cardiovascular events, as per all diabetic patients. In addition, weight loss induced by bariatric surgery seems to also be effective in improving liver features, together with the benefits for diabetes control or resolution, dyslipidemia, and hypertension. Finally, liver transplantation represents the ultimate treatment for severe nonalcoholic fatty liver disease and is growing rapidly as a main indication in Western countries. This review offers a comprehensive multidisciplinary approach to NAFLD, highlighting its connection with diabetes.
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影响因子：
4.2
作者：
Caussy C;Aubin A;Loomba R
通讯作者：
Loomba R
影响因子：
5.6
作者：
Di Ciaula A;Bonfrate L;Krawczyk M;Frühbeck G;Portincasa P
通讯作者：
Portincasa P
影响因子：
16.2
作者：
通讯作者：
--
DOI：
10.1002/hep.29797
发表时间：
2018-08
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Caussy C;Reeder SB;Sirlin CB;Loomba R
通讯作者：
Loomba R
影响因子：
2.9
作者：
Cazzo, Everton;Jimenez, Laisa Simakawa;Chaim, Elinton Adami
通讯作者：
Chaim, Elinton Adami