Filippatos Theodosios D, Elisaf Moses S
Theodosios D Filippatos, Moses S Elisaf, Department of Internal Medicine, University of Ioannina, Ioannina 45110, Greece.
World J Hepatol. 2010 Apr 27;2(4):139-42. doi: 10.4254/wjh.v2.i4.139.
Non-alcoholic fatty liver disease (NAFLD) includes simple steatosis, a benign condition, and non-alcoholic steatohepatitis, a condition that beyond TG accumulation also includes necroinflammation and fibrosis. An association between NAFLD and cardiovascular disease (CVD) has been recently suggested. NAFLD patients usually have an increased CVD risk profile. NAFLD is also associated with metabolic syndrome (MetS) and is considered as the hepatic component of MetS by some authors. Currently, the only established treatment of NAFLD is gradual weight loss. However, multifactorial treatment of NAFLD risk factors may be needed to reduce the increased CVD risk of NALFD patients. Drug combinations that include antiobesity drugs (such as orlistat and sibutramine) and target CVD risk factors may be a good approach to NAFLD patients. Our group has investigated the orlistat-fenofibrate combination treatment in obese patients with MetS and the orlistat-ezetimibe and sibutramine-antihypertensive combination treatment in obese patients with hyperlipidaemia with promising results in CVD risk factor reduction and improvement of liver function tests. Small studies give promising results but double-blind, randomized trials examining the effects of such multifactorial treatment in hard CVD endpoints in NAFLD patients are missing.
非酒精性脂肪性肝病（NAFLD）包括单纯性脂肪变性（一种良性病症）和非酒精性脂肪性肝炎（这种病症除了甘油三酯蓄积外，还包括坏死性炎症和纤维化）。最近有人提出NAFLD与心血管疾病（CVD）之间存在关联。NAFLD患者通常具有更高的CVD风险特征。NAFLD还与代谢综合征（MetS）相关，一些作者认为它是MetS的肝脏组成部分。目前，NAFLD唯一已确立的治疗方法是逐渐减轻体重。然而，可能需要对NAFLD危险因素进行多因素治疗，以降低NAFLD患者增加的CVD风险。包括抗肥胖药物（如奥利司他和西布曲明）并针对CVD危险因素的药物组合可能是治疗NAFLD患者的一种好方法。我们小组研究了奥利司他 - 非诺贝特联合治疗对患有MetS的肥胖患者的效果，以及奥利司他 - 依泽替米贝和西布曲明 - 抗高血压联合治疗对患有高脂血症的肥胖患者的效果，在降低CVD危险因素和改善肝功能检查方面取得了有前景的结果。小型研究给出了有前景的结果，但缺少双盲、随机试验来检验这种多因素治疗对NAFLD患者严重CVD终点的影响。
