Wah-Kheong Chan, Khean-Lee Goh
Gastroenterology and Hepatology Unit, Gastrointestinal Endoscopy Unit, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Hepatol Int. 2013 Mar;7(1):65-71. doi: 10.1007/s12072-012-9384-1. Epub 2012 Jun 15.
Non-alcoholic fatty liver disease (NAFLD) is rapidly increasing in the Asia-Pacific and affects up to 30 % of the general population. In younger children, prevalence has been reported to be between 2.1 and 4.5 %. The prevalence of NAFLD increases with increasing age. NAFLD is more prevalent in men than women, but this trend fades in older age group. NAFLD is one of the most common causes of raised serum ALT levels and the latter is closely related to the presence of features of metabolic syndrome. NAFLD may contribute to metabolic syndrome in a similar way as visceral adiposity and can be an early predictor of metabolic disorders. NAFLD increases the risk of developing diabetes mellitus and is closely related to degree of glucose intolerance. A significant proportion of patients with NAFLD have impaired glucose tolerance or diabetes mellitus but with normal fasting blood glucose, highlighting the importance of oral glucose tolerance test in NAFLD patients with normal fasting blood glucose. Besides liver-related complications, NAFLD has been associated with cardiovascular complications, hyperuricemia, gout, chronic kidney disease, gallstone disease, colorectal adenomatous polyp, and polycystic ovarian syndrome. NAFLD seems to be related to host metabolic factors rather than viral factors and does not seem to affect severity of the liver disease in patients with chronic hepatitis B. On the other hand, hepatic steatosis may be related to both host metabolic and viral factors in patients with chronic hepatitis C and seems to adversely impact on the severity of liver disease and possibly response to antiviral therapy.
非酒精性脂肪性肝病（NAFLD）在亚太地区正迅速增加，影响着高达30%的普通人群。在年幼儿童中，据报道患病率在2.1%至4.5%之间。NAFLD的患病率随年龄增长而增加。NAFLD在男性中比女性更普遍，但这种趋势在老年人群中逐渐减弱。NAFLD是血清ALT水平升高的最常见原因之一，而血清ALT水平升高与代谢综合征的特征密切相关。NAFLD可能以与内脏肥胖相似的方式导致代谢综合征，并且可能是代谢紊乱的早期预测指标。NAFLD增加了患糖尿病的风险，并且与葡萄糖不耐受程度密切相关。相当一部分NAFLD患者有糖耐量受损或糖尿病，但空腹血糖正常，这凸显了口服葡萄糖耐量试验在空腹血糖正常的NAFLD患者中的重要性。除了肝脏相关并发症外，NAFLD还与心血管并发症、高尿酸血症、痛风、慢性肾脏病、胆结石病、结直肠腺瘤性息肉和多囊卵巢综合征有关。NAFLD似乎与宿主代谢因素而非病毒因素有关，并且似乎不影响慢性乙型肝炎患者的肝病严重程度。另一方面，肝脂肪变性在慢性丙型肝炎患者中可能与宿主代谢和病毒因素都有关，并且似乎对肝病严重程度有不利影响，可能还会对抗病毒治疗反应产生影响。
