Northwestern University Feinberg School of Medicine, Department of Internal Medicine, Division of Gastroenterology and Hepatology, 676 N. St. Clair Street, Arkes Pavillion, 14-005, Chicago, Illinois 60527, USA.
Virginia Commonwealth University, 1200 East Broad Street, MCV BOX 980341, Richmond, Virginia 23298-0341, USA.
Nat Rev Gastroenterol Hepatol. 2016 Apr;13(4):196-205. doi: 10.1038/nrgastro.2016.3. Epub 2016 Feb 24.
NAFLD is the most prevalent form of liver disease in the USA, affecting an estimated 30% of the population. The condition is associated with increased mortality related to cardiovascular disease, malignancy and liver disease. Identification of patients who might be at increased risk of adverse outcomes is critical as it is not feasible to screen all patients with suspected NAFLD. Patients with NASH, the progressive subtype of NAFLD, should be targeted for treatment, especially if they have concomitant fibrosis because such patients are more likely than those without fibrosis to have adverse outcomes. Treatment goals in patients with NAFLD vary depending on the disease stage owing to differential risk of progression and the particularities of an individual's comorbid disease. Lifestyle intervention is important for all patients irrespective of disease stage, but other therapies should be targeted to those most likely to benefit. In this Review, we highlight risk factors for disease progression and offer a stage-based treatment approach for patients with NAFLD.
非酒精性脂肪性肝病（NAFLD）是美国最常见的肝脏疾病，估计有 30%的人群受其影响。该疾病与心血管疾病、恶性肿瘤和肝脏疾病相关的死亡率增加有关。识别可能存在不良结局风险的患者至关重要，因为对所有疑似 NAFLD 患者进行筛查是不可行的。非酒精性脂肪性肝炎（NASH）是 NAFLD 的进展型亚型，应针对此类患者进行治疗，尤其是如果他们同时存在纤维化，因为与没有纤维化的患者相比，此类患者更有可能出现不良结局。由于进展风险的差异以及个体合并疾病的特殊性，NAFLD 患者的治疗目标因疾病阶段而异。无论疾病阶段如何，生活方式干预对所有患者都很重要，但其他治疗方法应针对最有可能受益的患者。在这篇综述中，我们强调了疾病进展的危险因素，并为 NAFLD 患者提供了一种基于疾病阶段的治疗方法。
