Satapathy Sanjaya K, Sanyal Arun J
Division of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee.
Division of Gastroenterology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Semin Liver Dis. 2015 Aug;35(3):221-35. doi: 10.1055/s-0035-1562943. Epub 2015 Sep 17.
The epidemic of obesity has resulted in a parallel incremental burden of nonalcoholic fatty liver disease (NAFLD) worldwide. Nonalcoholic fatty liver disease includes a spectrum of liver disease that ranges from simple fat accumulation in the liver to necroinflammation, fibrosis, cirrhosis, and hepatocellular carcinoma, which in essence represent the stages of the natural history of NAFLD. The rising prevalence of NAFLD globally may be accounted for by changes in dietary habits and an increase in sedentary lifestyle. Nonalcoholic steatohepatitis (NASH), the aggressive form of NAFLD, is currently the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. In the current review, the authors discuss the uncertainty around the progression from NAFL (steatosis) to NASH (steatohepatitis), the undisputed progression of NASH to cirrhosis, and the risk factors that predispose to such progression. The published literature on the long-term cardiovascular complications and liver-related mortality of NAFLD is also discussed.
肥胖症的流行在全球范围内导致了非酒精性脂肪性肝病（NAFLD）负担的相应增加。非酒精性脂肪性肝病包括一系列肝脏疾病，从肝脏单纯脂肪堆积到坏死性炎症、纤维化、肝硬化和肝细胞癌，这些实质上代表了NAFLD自然病程的各个阶段。全球NAFLD患病率的上升可能是由于饮食习惯的改变和久坐不动生活方式的增加。非酒精性脂肪性肝炎（NASH）是NAFLD的侵袭性形式，目前是美国等待肝移植的成年人中第二大肝病病因。在当前的综述中，作者讨论了从NAFL（脂肪变性）进展到NASH（脂肪性肝炎）的不确定性、NASH发展为肝硬化这一无可争议的过程以及易导致这种进展的危险因素。还讨论了关于NAFLD长期心血管并发症和肝脏相关死亡率的已发表文献。
