Abdelmalek Manal F, Diehl Anna Mae
Division of Gastroenterology, Hepatology, and Nutrition, Duke University Medical Center, PO Box 3913, Durham, NC 27710, USA.
Med Clin North Am. 2007 Nov;91(6):1125-49, ix. doi: 10.1016/j.mcna.2007.06.001.
Nonalcoholic fatty liver disease (NAFLD) refers to a spectrum of liver damage ranging from simple steatosis to nonalcoholic steatohepatitis, advanced fibrosis, and rarely, progression to cirrhosis. The pathogenesis of NAFLD is thought to be related to insulin resistance and oxidant stress. Truncal obesity, dyslipidema, hypertension, and hyperglycemia are strongly associated with NAFLD; therefore, management of NAFLD entails identification and treatment of metabolic risk factors, improving insulin sensitivity, and increasing antioxidant defenses in the liver. This article briefly summarizes advances in our understanding of the relationship between NAFLD and the insulin resistance (metabolic) syndrome, its prevalence, natural history, and treatment.
非酒精性脂肪性肝病(NAFLD)指一系列肝脏损伤,范围从单纯性脂肪变性到非酒精性脂肪性肝炎、进展性肝纤维化,极少情况下会发展为肝硬化。NAFLD的发病机制被认为与胰岛素抵抗和氧化应激有关。腹型肥胖、血脂异常、高血压和高血糖与NAFLD密切相关;因此,NAFLD的管理需要识别和治疗代谢危险因素、改善胰岛素敏感性以及增强肝脏的抗氧化防御能力。本文简要总结了我们对NAFLD与胰岛素抵抗(代谢)综合征之间关系、其患病率、自然病程及治疗的认识进展。