Non-alcoholic fatty liver disease.
Non-alcoholic fatty liver disease.
复制标题
非酒精性脂肪肝。
DOI：
10.1136/bmj.g4596
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发表时间：
2014-07-29
期刊：
影响因子：
--
通讯作者：
Preiss D
中科院分区：
文献类型：
--
作者：
Sattar N;Forrest E;Preiss D
由于肥胖率的迅速上升，非酒精性脂肪性肝病(NAFLD)现在比酒精性肝病更常见，1而NAFLD是肝功能检查异常的最常见原因。2它在世界范围内的流行率被认为在普通人群中约为20%，在2型糖尿病患者中高达70%。3当脂肪含量超过肝脏体积的5%时，NAFLD的第一个可识别阶段是肝脏脂肪变性。就进展为更严重的肝病的风险而言，单纯性脂肪变性通常是良性的，但鉴于其高患病率，它仍然是肝硬变的重要原因。4值得注意的是，NAFLD与胰岛素抵抗和高血糖密切相关，因此与2型糖尿病密切相关。非酒精性脂肪性肝炎(NASH)是NAFLD的下一阶段，当肝脏炎症接踵而至时发生，其在普通人群中的患病率估计为3-5%3；NASH患者发生临床显著和进行性肝纤维化、肝硬变和肝细胞癌的风险要高得多。4 5个相关的临床问题，包括如何评估肝功能异常检查结果，识别NAFLD是否重要，如何实用地识别可能患有NASH的患者，以及谁应该转介给专家评估。在这篇文章中，我们概述了NAFLD如何在初级保健中被识别，我们建议何时需要进一步的研究，并说明为什么NAFLD应该是可持续减肥的强大驱动因素，以降低代谢和潜在的肝脏风险。
Non-alcoholic fatty liver disease (NAFLD) is now more common than alcoholic liver disease owing to the rapid rise in the prevalence of obesity, 1 and NAFLD is the most common cause of abnormal liver function tests. 2 Its prevalence worldwide is thought to be approximately 20% in the general population and up to 70% in patients with type 2 diabetes mellitus. 3 The first recognisable stage of NAFLD is hepatic steatosis, when fat content exceeds 5% of liver volume. Simple steatosis is usually benign in terms of risk of progression to more advanced liver disease, but given its high prevalence it none the less represents an important cause of cirrhosis. 4 Notably, NAFLD is strongly associated with insulin resistance and hyperglycaemia and it is therefore closely linked to type 2 diabetes. Non-alcoholic steatohepatitis (NASH), the next stage of NAFLD, develops when hepatic inflammation ensues, and its prevalence in the general population is estimated at 3-5% 3; people with NASH are at much higher risk of clinically significant and progressive liver fibrosis, cirrhosis, and hepatocellular carcinoma. 4 5 Relevant clinical questions include how to evaluate abnormal liver function test results, whether it is important to identify NAFLD, how to pragmatically identify patients who may have NASH, and who to refer for specialist evaluation. In this article we outline how NAFLD may be recognised in primary care, we suggest when further investigations are needed, and we show why NAFLD should be a strong driver for sustainable weight loss to reduce metabolic and, potentially, hepatic risks.
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影响因子：
3
作者：
Utzschneider KM;Largajolli A;Bertoldo A;Marcovina S;Nelson JE;Yeh MM;Kowdley KV;Kahn SE
通讯作者：
Kahn SE
影响因子：
16.2
作者：
Fraser A;Harris R;Sattar N;Ebrahim S;Davey Smith G;Lawlor DA
通讯作者：
Lawlor DA
影响因子：
16.2
作者：
通讯作者：
--
DOI：
10.1136/bmj.c1240
发表时间：
2010-03-11
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Hart CL;Morrison DS;Batty GD;Mitchell RJ;Davey Smith G
通讯作者：
Davey Smith G
影响因子：
168.9
作者：
Athyros, Vasilios G.;Tziomalos, Konstantinos;Mikhailidis, Dimitri P.
通讯作者：
Mikhailidis, Dimitri P.