非酒精性脂肪肝概述

Mohammed Salah Debes
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引用次数: 7

摘要

脂肪肝是一种常见的肝脏疾病,可以是酒精性(AFLD),当有显著的酒精摄入或非酒精性(NAFLD),当其他原因的肝脏脂肪变性被排除,特别是显著的酒精摄入和病毒性肝炎。NAFLD的病程可能有两种极端之一,要么是良性单纯性脂肪变性,要么是被称为NASH的脂肪性肝炎,NASH可导致进行性肝脏炎症、肝硬化甚至肝细胞癌,并且被认为是之前被标记为隐源性肝硬化的人肝硬化的重要原因。NASH占美国肝移植病例的10%以上,不幸的是移植后有复发的风险。潜在的原因是多因素的,与遗传和后天因素有关,后天因素大多是可以改变的,与生活方式有关,特别是在久坐不动的人群中,卡路里摄入量增加,消耗有限,这导致超重/肥胖,胰岛素抵抗和甘油三酯在肝脏中积累。因此,管理将主要依赖于扭转这些消极的生活方式,所以强调三合一:饮食,运动和减肥。在这篇综述将集中在成人非酒精性脂肪性肝病,给出全面的概述,包括最新的建议管理在临床实践中。
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Non Alcoholic Fatty Liver Overview
Fatty liver disease is one of the common liver diseases, could be alcoholic (AFLD) when there is significant alcohol intake or non-alcoholic (NAFLD), when other causes of liver steatosis are ruled out in particular significant alcohol intake and viral hepatitis. The course of NAFLD could have one of two extremes, either benign simple steatosis or steatohepatitis known as NASH that could lead to progressive liver inflammation, cirrhosis and even hepatocellular carcinoma HCC, and is believed to be important cause for liver cirrhosis in those labeled before as cryptogenic cirrhosis. NASH represents more than 10% of liver transplant cases in the USA and unfortunately there is risk of recurrence post-transplant. The underlying cause is multifactorial, related to genetic and acquired factors, the acquired factors are mostly modifiable, related to lifestyle particularly increased calorie intake with limited consumption in people leading sedentary life, and this leads to overweight / obesity, insulin resistance and triglycerides accumulation in the liver. And so the management will mainly rely on reversal of these lifestyle negatives, so stress on the triad: Diet, exercise and weight reduction. In this review will focus on non-alcoholic fatty liver disease in adults, giving comprehensive overview including the latest recommendations about the management in clinical practice.
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