Pallayova M, Taheri S
Faculty of Medicine, PJ Safarik University, Kosice, Slovak Republic.
Clin Obes. 2014 Oct;4(5):243-53. doi: 10.1111/cob.12068. Epub 2014 Jul 28.
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder whose prevalence is strongly linked to the current epidemic of obesity in many western countries. The prevalence of NAFLD is two to four times higher in populations with pre-existing metabolic comorbidities than in the general population. The diagnosis of primary NAFLD involves establishing the presence of hepatic steatosis or steatohepatitis by imaging or histology, along with establishing the non-alcoholic nature of the disease process and excluding competing aetiologies for hepatic steatosis. Among the indirect serum biomarkers, the NAFLD fibrosis score can help to identify patients with NAFLD and with higher likelihood of having fibrosis or cirrhosis. A liver biopsy should be considered in NAFLD patients at increased risk for steatohepatitis/advanced fibrosis and in cases where a liver biopsy is necessary to exclude co-existing chronic liver diseases and other aetiologies for hepatic steatosis. The treatment and management recommendations for obesity-associated NAFLD are aimed towards weight reduction. The currently available interventions employed to promote weight loss and improve the metabolic responses in NAFLD include lifestyle modification, pharmacotherapy and bariatric surgery.
非酒精性脂肪性肝病（NAFLD）是最常见的慢性肝脏疾病，其患病率与许多西方国家当前的肥胖流行密切相关。在已有代谢合并症的人群中，NAFLD的患病率比普通人群高两到四倍。原发性NAFLD的诊断包括通过影像学或组织学确定肝脂肪变性或脂肪性肝炎的存在，同时确定疾病过程的非酒精性性质，并排除肝脂肪变性的其他病因。在间接血清生物标志物中，NAFLD纤维化评分有助于识别患有NAFLD且更有可能发生纤维化或肝硬化的患者。对于发生脂肪性肝炎/晚期纤维化风险增加的NAFLD患者，以及需要进行肝活检以排除并存的慢性肝病和肝脂肪变性其他病因的情况，应考虑进行肝活检。肥胖相关NAFLD的治疗和管理建议旨在减轻体重。目前用于促进体重减轻和改善NAFLD代谢反应的干预措施包括生活方式改变、药物治疗和减肥手术。
