Department of Gastroenterology and Hepatology, Mie University School of Medicine, Tsu, Mie, Japan.
Hepatol Res. 2011 Oct;41(10):911-20. doi: 10.1111/j.1872-034X.2011.00867.x.
Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease worldwide and its incidence is increasing concomitantly with the increase in the prevalence of metabolic syndrome. Fatty liver encompasses a broad pathological spectrum of disease, from relatively benign accumulation of fat (simple steatosis) to progressive non-alcoholic steatohepatitis (NASH), which is associated with necroinflammation and fibrosis. Approximately 20-30% of the Japanese population is estimated to have NAFLD, 10% of which is suggested to have NASH. The most worrisome feature of NASH is the potential progression to cirrhosis, hepatocellular carcinoma (HCC), and finally, mortality. Several factors, such as insulin resistance, adipokines, endotoxins and oxidative stress, are involved in the pathogenesis of NASH. However, the precise etiological mechanism of NAFLD/NASH has yet to be elucidated. This article reviews the clinical background, pathogenesis, new diagnostic approaches and future directions regarding NAFLD/NASH.
非酒精性脂肪性肝病（NAFLD）是全球最常见的慢性肝病，其发病率随着代谢综合征患病率的增加而同步上升。脂肪肝涵盖了广泛的疾病病理谱，从相对良性的脂肪堆积（单纯性脂肪变性）到进展性非酒精性脂肪性肝炎（NASH），后者与坏死性炎症和纤维化有关。据估计，约 20-30%的日本人患有 NAFLD，其中 10%可能患有 NASH。NASH 最令人担忧的特征是可能进展为肝硬化、肝细胞癌（HCC），最终导致死亡。胰岛素抵抗、脂肪因子、内毒素和氧化应激等多种因素参与了 NASH 的发病机制。然而，NAFLD/NASH 的确切病因机制尚未阐明。本文综述了 NAFLD/NASH 的临床背景、发病机制、新的诊断方法和未来的发展方向。
