Chemical Pathology Department, Southampton University Hospital NHS Trust, Southampton, UK.
Prim Care Diabetes. 2010 Oct;4(3):129-37. doi: 10.1016/j.pcd.2010.02.004. Epub 2010 Mar 17.
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of hepatic dysfunction encountered in general practice. A large proportion of individuals with type 2 diabetes and the metabolic syndrome develop NAFLD. NAFLD is associated with severe insulin resistance and increased risk of cardiovascular disease and can progress to non-alcoholic steato-hepatitis, liver cirrhosis and cancer. Currently the only known effective treatments for NAFLD are lifestyle changes including stable weight loss and a diet low in calories. General practitioners will increasingly play a key role in dealing with this evolving but serious epidemic of NAFLD and associated metabolic complications. However, success will depend on the appropriate systems and mechanisms being in place in primary care and the proper motivation, support and education of the patient. This review provides the primary care physician with: (a) a step-by step guide of how to identify NAFLD, (b) information to exclude common other causes of liver fat accumulation and (c) additional insight into relationships between NAFLD and other conditions such as obesity, cardiovascular disease and type 2 diabetes.
非酒精性脂肪性肝病（NAFLD）是普通医学实践中最常见的肝功能障碍原因。很大一部分 2 型糖尿病和代谢综合征患者会发展为 NAFLD。NAFLD 与严重的胰岛素抵抗以及心血管疾病风险增加相关，并可能进展为非酒精性脂肪性肝炎、肝硬化和癌症。目前，NAFLD 的唯一已知有效治疗方法是生活方式改变，包括稳定减肥和低热量饮食。全科医生将在应对这种不断演变但严重的 NAFLD 及其相关代谢并发症方面发挥关键作用。然而，成功将取决于初级保健中适当的系统和机制以及对患者的适当激励、支持和教育。本综述为初级保健医生提供：（a）如何识别 NAFLD 的分步指南，（b）排除常见其他肝脏脂肪堆积原因的信息，以及（c）对 NAFLD 与肥胖症、心血管疾病和 2 型糖尿病等其他疾病之间关系的更多了解。
