Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis 2020.
Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis 2020.
复制标题
DOI：
10.1007/s00535-021-01796-x
复制
发表时间：
2021-11
影响因子：
6.3
通讯作者：
Koike K
中科院分区：
文献类型：
--
作者：
Tokushige K;Ikejima K;Ono M;Eguchi Y;Kamada Y;Itoh Y;Akuta N;Yoneda M;Iwasa M;Yoneda M;Otsuka M;Tamaki N;Kogiso T;Miwa H;Chayama K;Enomoto N;Shimosegawa T;Takehara T;Koike K
非酒精性脂肪性肝病(NAFLD)不仅在西方国家，在日本也已经成为一个严重的公共卫生问题。在NAFLD的广泛范围内，非酒精性脂肪性肝炎(NASH)是一种进行性疾病，通常发展为肝硬变，并增加肝细胞癌(HCC)的风险。虽然NASH的明确诊断需要肝活检来确认肝细胞气球的存在，但肝纤维化是NAFLD最重要的预后因素。在NAFLD患者众多的情况下，有必要建立一种有效的NAFLD肝纤维化筛查方法。随着非病毒性肝病肝细胞癌在日本的显著增加，也迫切需要对肝细胞癌进行有效的筛查和监测。NAFLD患者最常见的死因是心血管疾病(CVD)事件。因此，胃肠病专家在检查NAFLD患者时必须密切关注心血管疾病。在更新的指南中，我们建议对NAFLD患者的肝纤维化、肝细胞癌和心血管疾病进行筛查和随访。NAFLD/NASH疗法的几个药物试验正在进行中，然而，目前还没有针对NAFLD/NASH的特效药物疗法。除了维生素E和噻唑烷二酮类化合物外，最近的试验主要集中在葡萄糖共转运蛋白2(SGLT2)抑制剂和胰升糖素样肽-1(GLP-1)类似物上，并有望开发出有效的治疗方法。这些NAFLD/NASH的实用指南是由日本胃肠病学会与日本肝病学会共同制定的。收集1983年至2018年10月期间国际报道的临床证据，并使用推荐评估、发展和评估(GRADE)系统对每个临床和背景问题进行评估。这份英文摘要提供了这些临床实践指南的核心要点，其中包括定义和概念、肝纤维化、肝细胞癌和心血管疾病的筛查系统，以及日本目前治疗NAFLD/NASH的方法。
Nonalcoholic fatty liver disease (NAFLD) has become a serious public health issue not only in Western countries but also in Japan. Within the wide spectrum of NAFLD, nonalcoholic steatohepatitis (NASH) is a progressive form of disease that often develops into liver cirrhosis and increases the risk of hepatocellular carcinoma (HCC). While a definite diagnosis of NASH requires liver biopsy to confirm the presence of hepatocyte ballooning, hepatic fibrosis is the most important prognostic factor in NAFLD. With so many NAFLD patients, it is essential to have an effective screening method for NAFLD with hepatic fibrosis. As HCC with non-viral liver disease has increased markedly in Japan, effective screening and surveillance of HCC are also urgently needed. The most common death etiology in NAFLD patients is cardiovascular disease (CVD) event. Gastroenterologists must, therefore, pay close attention to CVD when examining NAFLD patients. In the updated guidelines, we propose screening and follow-up methods for hepatic fibrosis, HCC, and CVD in NAFLD patients. Several drug trials are ongoing for NAFLD/NASH therapy, however, there is currently no specific drug therapy for NAFLD/NASH. In addition to vitamin E and thiazolidinedione derivatives, recent trials have focused on sodium glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) analogues, and effective therapies are expected to be developed. These practical guidelines for NAFLD/NASH were established by the Japanese Society of Gastroenterology in conjunction with the Japan Society of Hepatology. Clinical evidence reported internationally between 1983 and October 2018 was collected, and each clinical and background question was evaluated using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system. This English summary provides the core essentials of these clinical practice guidelines, which include the definition and concept, screening systems for hepatic fibrosis, HCC and CVD, and current therapies for NAFLD/NASH in Japan.
登录
查看更多内容
DOI：
10.1002/hep.29273
发表时间：
2017-10
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
BasuRay S;Smagris E;Cohen JC;Hobbs HH
通讯作者：
Hobbs HH
影响因子：
25.7
作者：
Armstrong MJ;Hull D;Guo K;Barton D;Hazlehurst JM;Gathercole LL;Nasiri M;Yu J;Gough SC;Newsome PN;Tomlinson JW
通讯作者：
Tomlinson JW
影响因子：
29.4
作者：
Cotter, Thomas G.;Rinella, Mary
通讯作者：
Rinella, Mary
影响因子：
12.6
作者：
Bravi, Francesca;Bosetti, Cristina;La Vecchia, Carlo
通讯作者：
La Vecchia, Carlo
DOI：
10.1002/hep.29477
发表时间：
2018-05
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Friedman SL;Ratziu V;Harrison SA;Abdelmalek MF;Aithal GP;Caballeria J;Francque S;Farrell G;Kowdley KV;Craxi A;Simon K;Fischer L;Melchor-Khan L;Vest J;Wiens BL;Vig P;Seyedkazemi S;Goodman Z;Wong VW;Loomba R;Tacke F;Sanyal A;Lefebvre E
通讯作者：
Lefebvre E