Bayard Max, Holt Jim, Boroughs Eileen
Department of Family Medicine, East Tennessee State University, Quillen College of Medicine, Johnson City, Tennessee 37604, USA.
Am Fam Physician. 2006 Jun 1;73(11):1961-8.
Nonalcoholic fatty liver disease is a common condition associated with metabolic syndrome. It is the most common cause of elevated liver enzymes in U.S. adults, and is diagnosed after ruling out other causes of steatosis (fatty infiltration of liver), particularly infectious hepatitis and alcohol abuse. Liver biopsy may be considered if greater diagnostic and prognostic certainty is desired, particularly in patients with diabetes, patients who are morbidly obese, and in patients with an aspartate transaminase to alanine transaminase ratio greater than one, because these patients are at risk of having more advanced disease. Weight loss is the primary treatment for obese patients with nonalcoholic fatty liver disease. Medications used to treat insulin resistance, hyperlipidemia, and obesity have been shown to improve transaminase levels, steatosis, and histologic findings. However, no treatments have been shown to affect patient-oriented outcomes.
非酒精性脂肪性肝病是一种与代谢综合征相关的常见病症。它是美国成年人肝酶升高的最常见原因，在排除其他脂肪变性（肝脏脂肪浸润）原因后确诊，尤其是传染性肝炎和酒精滥用。如果需要更高的诊断和预后确定性，可考虑进行肝活检，特别是对于糖尿病患者、病态肥胖患者以及天冬氨酸转氨酶与丙氨酸转氨酶比值大于1的患者，因为这些患者有患更晚期疾病的风险。减肥是肥胖的非酒精性脂肪性肝病患者的主要治疗方法。用于治疗胰岛素抵抗、高脂血症和肥胖症的药物已被证明可改善转氨酶水平、脂肪变性和组织学表现。然而，尚无治疗方法被证明会影响以患者为导向的结局。
