SYSTEMATIC REVIEW WITH COMPARATIVE ANALYSIS OF RECOMMENDATIONS FOR THE DIAGNOSIS OF NONALCOHOLIC FATTY LIVER DISEASE

N. Toktogulova
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Abstract

A review of the available literature has shown that the current epidemic of nonalcoholic fatty liver disease (NAFLD) is closely related with the widespread prevalence of metabolic risk factors worldwide, such as obesity, type 2 diabetes, and dyslipidemia. In parallel with the increasing availability of effective antiviral drugs, NAFLD is rapidly becoming the most common cause of chronic liver disease in Western countries, and a similar trend is expected in Eastern countries in the coming years. This epidemic and its aftermath have prompted experts from around the world to identify effective strategies for the diagnosis, management and treatment of NAFLD. Various scientific associations from America, Europe and the Asia-Pacific region have offered recommendations based on the most recent data on NAFLD. These recommendations are consistent with the key elements of NAFLD management, but at the same time, there are significant differences in some critical points. We have identified clinical guidelines from 8 different scientific societies with a worldwide reputation, and tried to conduct a systematic and comparative analysis of the presented protocols. Differences were noted in: definition of NAFLD, screening for NAFLD in high-risk patients, a non-invasive test proposed to diagnose NAFLD and identify NAFLD patients with severe fibrosis, follow-up protocols, and finally, treatment strategy
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非酒精性脂肪肝诊断建议的系统评价与比较分析
对现有文献的回顾表明,当前非酒精性脂肪性肝病(NAFLD)的流行与世界范围内代谢危险因素的广泛流行密切相关,如肥胖、2型糖尿病和血脂异常。随着有效抗病毒药物的日益普及,NAFLD正迅速成为西方国家慢性肝病最常见的病因,预计未来几年东方国家也将出现类似的趋势。这一流行病及其后果促使世界各地的专家确定NAFLD的诊断、管理和治疗的有效战略。来自美国、欧洲和亚太地区的各种科学协会根据NAFLD的最新数据提出了建议。这些建议与NAFLD治疗的关键要素一致,但同时在一些关键点上存在显著差异。我们已经确定了来自8个不同的具有世界声誉的科学学会的临床指南,并试图对所提出的协议进行系统和比较分析。差异体现在:NAFLD的定义、高危患者的NAFLD筛查、诊断NAFLD并识别严重纤维化NAFLD患者的非侵入性检测、随访方案以及最终的治疗策略
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