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非酒精性脂肪性肝病:非侵入性诊断的最新进展及其与心血管疾病的关联

Nonalcoholic fatty liver disease: updates in noninvasive diagnosis and correlation with cardiovascular disease.

作者信息

Hu Kuang-Chun, Wang Horng-Yuan, Liu Sung-Chen, Liu Chuan-Chuan, Hung Chung-Lieh, Bair Ming-Jong, Liu Chun-Jen, Wu Ming-Shiang, Shih Shou-Chuan

机构信息

Kuang-Chun Hu, Horng-Yuan Wang, Chuan-Chuan Liu, Shou-Chuan Shih, Mackay Medical College, New Taipei City 25245, Taiwan.

出版信息

World J Gastroenterol. 2014 Jun 28;20(24):7718-29. doi: 10.3748/wjg.v20.i24.7718.

Abstract

Nonalcoholic fatty liver disease (NAFLD) refers to the accumulation of fat (mainly triglycerides) within hepatocytes. Approximately 20%-30% of adults in the general population in developed countries have NAFLD; this trend is increasing because of the pandemicity of obesity and diabetes, and is becoming a serious public health burden. Twenty percent of individuals with NAFLD develop chronic hepatic inflammation [nonalcoholic steatohepatitis (NASH)], which can be associated with the development of cirrhosis, portal hypertension, and hepatocellular carcinoma in a minority of patients. And thus, the detection and diagnosis of NAFLD is important for general practitioners. Liver biopsy is the gold standard for diagnosing NAFLD and confirming the presence of NASH. However, the invasiveness of this procedure limits its application to screening the general population or patients with contraindications for liver biopsy. The development of noninvasive diagnostic methods for NAFLD is of paramount importance. This review focuses on the updates of noninvasive diagnosis of NAFLD. Besides, we review clinical evidence supporting a strong association between NAFLD and the risk of cardiovascular disease because of the cross link between these two disorders.

摘要

非酒精性脂肪性肝病(NAFLD)是指肝细胞内脂肪(主要是甘油三酯)的蓄积。在发达国家,普通人群中约20%-30%的成年人患有NAFLD;由于肥胖和糖尿病的流行,这种趋势正在增加,并成为一个严重的公共卫生负担。20%的NAFLD患者会发展为慢性肝脏炎症[非酒精性脂肪性肝炎(NASH)],少数患者可能会出现肝硬化、门静脉高压和肝细胞癌。因此,NAFLD的检测和诊断对全科医生来说很重要。肝活检是诊断NAFLD和确认NASH存在的金标准。然而,该检查的侵入性限制了其在普通人群筛查或肝活检禁忌患者中的应用。开发NAFLD的非侵入性诊断方法至关重要。本综述重点关注NAFLD非侵入性诊断的最新进展。此外,由于这两种疾病之间的交叉联系,我们还综述了支持NAFLD与心血管疾病风险密切相关的临床证据。

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