Adams L A, Angulo P
School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Perth, Australia.
Postgrad Med J. 2006 May;82(967):315-22. doi: 10.1136/pgmj.2005.042200.
Non-alcoholic fatty liver disease (NAFLD) is common and may progress to cirrhosis and its complications. The pathogenesis of steatosis and cellular injury is thought to be related mostly to insulin resistance and oxidative stress. Therefore, management entails identification and treatment of metabolic risk factors, improving insulin sensitivity, and increasing antioxidant defences in the liver. Weight loss and exercise improve insulin sensitivity. Bariatric surgery may improve liver histology in patients with morbid obesity. Insulin sensitising drugs showed promise in pilot trials as have a number of hepatoprotective agents. Further randomised, well controlled trials are required to determine the efficacy of these drugs.
非酒精性脂肪性肝病（NAFLD）很常见，可能会进展为肝硬化及其并发症。脂肪变性和细胞损伤的发病机制被认为主要与胰岛素抵抗和氧化应激有关。因此，治疗需要识别和治疗代谢危险因素，提高胰岛素敏感性，并增强肝脏的抗氧化防御能力。体重减轻和运动可改善胰岛素敏感性。减肥手术可能会改善病态肥胖患者的肝脏组织学。胰岛素增敏药物在试点试验中显示出前景，一些肝保护剂也是如此。需要进一步进行随机、严格对照的试验来确定这些药物的疗效。
