Masarone Mario, Federico Alessandro, Abenavoli Ludovico, Loguercio Carmela, Persico Marcello
Via Alessandro Manzoni 26b, 80123, Naples, Italy.
Rev Recent Clin Trials. 2014;9(3):126-33. doi: 10.2174/1574887109666141216111143.
Non Alcoholic Fatty Liver Disease (NAFLD), defined as the presence of a significant amount of lipid accumulation in the liver (at least in 5% of hepatocytes), represents a challenging issue for the Hepatologists. NAFLD is not represented by a single entity, but rather by two different entities that have different natural history and evolution that range from simple fat accumulation in the liver (without any consequence), to necroinflammation, fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The reason of these differences has to be found in the host characteristics and associated risk factors. Globally, its prevalence among liver diseases, and in the general population, is rising in the recent years along with its associated conditions: obesity, insulin resistance, metabolic syndrome and diabetes. This increment, together with the reported clinical conditions, may be accounted for changes in dietary habits and the increase of sedentary lifestyle. Its diffusion seems to be pandemic, given that it is beginning to affect the populations in the developing world due to the spread of Western lifestyle. This is particularly worrying in young adults and children in what seems to have become the main cause of liver disease. Even if the real rate of global incidence of NAFLD are not known, its worldwide prevalence in general population is estimated to be 20-30% in Western Countries and 5-18% in Asia and it is increasing over time. In this review we will report on the global and regional prevalence of NAFLD, the principal risk factors and the natural history of its different presentations.
非酒精性脂肪性肝病（NAFLD）被定义为肝脏中存在大量脂质蓄积（至少5%的肝细胞受累），这对肝病学家来说是一个具有挑战性的问题。NAFLD并非单一的疾病实体，而是由两种不同的实体组成，它们具有不同的自然史和演变过程，范围从肝脏单纯脂肪蓄积（无任何后果）到坏死性炎症、纤维化、肝硬化和肝细胞癌（HCC）。这些差异的原因必须从宿主特征和相关危险因素中寻找。在全球范围内，近年来其在肝脏疾病以及普通人群中的患病率连同其相关疾病（肥胖、胰岛素抵抗、代谢综合征和糖尿病）一起呈上升趋势。这种上升，连同所报告的临床情况，可能是由于饮食习惯的改变和久坐不动生活方式的增加所致。鉴于西方生活方式的传播开始影响发展中世界的人群，其传播似乎呈全球流行态势。这在年轻人和儿童中尤其令人担忧，因为它似乎已成为肝病的主要原因。即使NAFLD的全球实际发病率尚不清楚，但据估计其在西方国家普通人群中的全球患病率为20% - 30%，在亚洲为5% - 18%，且随时间推移呈上升趋势。在本综述中，我们将报告NAFLD的全球和区域患病率、主要危险因素及其不同表现形式的自然史。
