Abd El-Kader Shehab M, El-Den Ashmawy Eman M Salah
Shehab M Abd El-Kader, Eman M Salah El-Den Ashmawy, Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
World J Hepatol. 2015 Apr 28;7(6):846-58. doi: 10.4254/wjh.v7.i6.846.
Non-alcoholic fatty liver disease (NAFLD) is now the most frequent chronic liver disease that occurs across all age groups and is recognized to occur in 14%-30% of the general population, representing a serious and growing clinical problem due to the growing prevalence of obesity and overweight. Histologically, it resembles alcoholic liver injury but occurs in patients who deny significant alcohol consumption. NAFLD encompasses a spectrum of conditions, ranging from benign hepatocellular steatosis to inflammatory nonalcoholic steatohepatitis, fibrosis, and cirrhosis. The majority of hepatocellular lipids are stored as triglycerides, but other lipid metabolites, such as free fatty acids, cholesterol, and phospholipids, may also be present and play a role in disease progression. NAFLD is associated with obesity and insulin resistance and is considered the hepatic manifestation of the metabolic syndrome, a combination of medical conditions including type 2 diabetes mellitus, hypertension, hyperlipidemia, and visceral adiposity. Confirmation of the diagnosis of NAFLD can usually be achieved by imaging studies; however, staging the disease requires a liver biopsy. Current treatment relies on weight loss and exercise, although various insulin-sensitizing agents, antioxidants and medications appear promising. The aim of this review is to highlight the current information regarding epidemiology, diagnosis, and management of NAFLD as well as new information about pathogenesis, diagnosis and management of this disease.
非酒精性脂肪性肝病（NAFLD）是目前在所有年龄组中最常见的慢性肝病，据公认在普通人群中的发病率为14%-30%，由于肥胖和超重患病率的不断上升，这已成为一个严重且日益突出的临床问题。从组织学上看，它类似于酒精性肝损伤，但发生在否认大量饮酒的患者中。NAFLD涵盖一系列病症，从良性肝细胞脂肪变性到炎症性非酒精性脂肪性肝炎、纤维化和肝硬化。大多数肝细胞脂质以甘油三酯形式储存，但其他脂质代谢产物，如游离脂肪酸、胆固醇和磷脂，也可能存在并在疾病进展中起作用。NAFLD与肥胖和胰岛素抵抗相关，被认为是代谢综合征的肝脏表现，代谢综合征是包括2型糖尿病、高血压、高脂血症和内脏肥胖在内的多种病症的组合。NAFLD的诊断通常可通过影像学检查来确定；然而，对该疾病进行分期则需要肝活检。目前的治疗依赖于体重减轻和运动，尽管各种胰岛素增敏剂、抗氧化剂和药物似乎前景良好。本综述的目的是强调有关NAFLD的流行病学、诊断和管理的当前信息，以及有关该疾病发病机制、诊断和管理的新信息。
