Singh Sital, Kuftinec Gabriela N, Sarkar Souvik
Division of Gastroenterology and Hepatology and Department of Internal Medicine, University of California, Davis, USA.
Department of Internal Medicine, University of California, Davis, USA.
J Clin Transl Hepatol. 2017 Mar 28;5(1):76-81. doi: 10.14218/JCTH.2016.00045. Epub 2017 Feb 7.
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are national and global epidemics. The disease is characterized by a spectrum of liver steatosis (fat deposition), inflammation (in NASH) and fibrosis. NAFLD and specifically NASH can lead to cirrhosis, which carry risks of progression to portal hypertension and hepatocellular carcinoma (HCC). NASH is also associated with higher mortality from cardiovascular causes. Most of the data for NAFLD has been obtained from the perspective of developed nations, although the disease is increasing and threatening to reach epidemic proportions across the world. Emerging data is notable for high prevalence of NAFLD in South Asian populations, presumably resulting from a combination of underlying genetic polymorphisms and changes in socio-economic status. It is also notable that an 'Asian Paradox' has been defined for NAFLD based upon the observation of lower than pre-defined body mass index (BMI), otherwise termed as "lean NAFLD", among this population. Yet, data remains limited in regards to the characteristics of NAFLD/NASH in this population. In this article, we present a review of the literature and discuss the prevalence, associated risk factors and burden of HCC in South Asians with NAFLD.
非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）在国内和全球范围内均呈流行态势。该疾病的特征是一系列肝脏脂肪变性（脂肪沉积）、炎症（在NASH中）和纤维化。NAFLD，特别是NASH，可导致肝硬化，进而有发展为门静脉高压和肝细胞癌（HCC）的风险。NASH还与心血管疾病导致的更高死亡率相关。NAFLD的大多数数据是从发达国家的角度获得的，尽管该疾病在全球范围内呈上升趋势并有可能达到流行程度。新出现的数据显示，南亚人群中NAFLD的患病率很高，这可能是潜在基因多态性和社会经济状况变化共同作用的结果。同样值得注意的是，基于对该人群中低于预先定义的体重指数（BMI），即所谓的“瘦型NAFLD”的观察，为NAFLD定义了一个“亚洲悖论”。然而，关于该人群中NAFLD/NASH特征的数据仍然有限。在本文中，我们对文献进行了综述，并讨论了南亚NAFLD患者的患病率、相关危险因素和HCC负担。
