Nugent Clare, Younossi Zobair M
Inova Fairfax Hospital Annandale, VA 22042, USA.
Nat Clin Pract Gastroenterol Hepatol. 2007 Aug;4(8):432-41. doi: 10.1038/ncpgasthep0879.
The clinicopathologic spectrum of nonalcoholic fatty liver disease (NAFLD) ranges from simple steatosis to nonalcoholic steatohepatitis (NASH). Simple steatosis has a relatively benign clinical course, but NASH can progress to cirrhosis and hepatocellular carcinoma. NAFLD occurs in the absence of significant alcohol use and is considered to be the hepatic manifestation of metabolic syndrome. NAFLD affects approximately 30% of the US population and the incidence seems to be rising as the obesity epidemic continues. At present, the most accurate modality for the diagnosis of NASH is liver biopsy; however, many patients do not have a liver biopsy, and in the absence of more-accurate imaging technologies and serum markers, the diagnosis is frequently one of exclusion. As yet there is no convincingly effective treatment for NAFLD--a multimodal treatment plan that targets obesity, insulin resistance, hyperlipidemia and hypertension might be the best option for these patients.
非酒精性脂肪性肝病（NAFLD）的临床病理谱范围从单纯性脂肪变性到非酒精性脂肪性肝炎（NASH）。单纯性脂肪变性具有相对良性的临床病程，但NASH可进展为肝硬化和肝细胞癌。NAFLD在无大量饮酒的情况下发生，被认为是代谢综合征的肝脏表现。NAFLD影响约30%的美国人口，且随着肥胖流行的持续，其发病率似乎在上升。目前，诊断NASH最准确的方法是肝活检；然而，许多患者未进行肝活检，且在缺乏更精确的成像技术和血清标志物的情况下，诊断往往是排除性诊断之一。迄今为止，尚无令人信服的有效治疗NAFLD的方法——针对肥胖、胰岛素抵抗、高脂血症和高血压的多模式治疗方案可能是这些患者的最佳选择。
