Pati Girish K, Singh Shivaram P
Department of Gastroenterology, Shri Ramachandra Bhanj Medical College, Cuttack, Odisha, India.
Kalinga Gastroenterology Foundation, Cuttack, Odisha, India.
Euroasian J Hepatogastroenterol. 2016 Jul-Dec;6(2):154-162. doi: 10.5005/jp-journals-10018-1189. Epub 2016 Dec 1.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the West, and is also increasing alarmingly in South Asia, reaching an epidemic proportion of 30% because of epidemic of obesity and metabolic syndrome (MS) in younger South Asians in the last two decades. Prevalence of MS and fatty liver is escalating in geometric progression in South Asian countries, such as India, Pakistan, Sri Lanka, Bangladesh, Nepal, Bhutan, Burma, and Maldives because of sedentary lifestyle, poor health awareness, socioeconomic growth, affluence, urbanization, and dietary westernization. Almost 20% of world's population resides in South Asia, making it the most populous and most densely populated geographic region in the world, thereby having most of MS and NAFLD cases within its territory. The risk factors and course of NAFLD do not differ between South Asians and other ethnic populations, but the obesity epidemic is more recent in South Asia than elsewhere in the world. Nonalcoholic fatty liver disease may progress through stages of simple bland steatosis, nonalcoholic steatohepatitis (NASH), hepatic fibrosis, cirrhosis, and finally hepatocellular carcinoma (HCC). It is frequently associated with obesity, MS, dyslipidemia, insulin resistance (IR), and type-2 diabetes mellitus (DM). Nonalcoholic fatty liver disease is frequently diagnosed with abdominal ultrasonography (US) study. Despite its high prevalence in the community till now, no definitive pharmacotherapy is available for NAFLD. However, modification of risk factors, such as dyslipidemia, control of diabetes, and weight reduction do help to some extent. The nonobese South Asians are also at increased risk of having NAFLD and NASH as, despite of absence of frank obesity in South Asians, they are metabolically more obese compared to other ethnic population and more prone to develop NAFLD-related complications. Therefore, the cost-effective US abdomen should be included in the list of tests for persons undergoing preemployment or master health checkups for early diagnosis of NAFLD in this resource-constraint South Asian region, so that early necessary measures can be undertaken to reduce NAFLD associated morbidity and mortality in the community.
Pati GK, Singh SP. Nonalcoholic Fatty Liver Disease in South Asia. Euroasian J Hepato-Gastroenterol 2016;6(2):154-162.
非酒精性脂肪性肝病（NAFLD）是西方最常见的慢性肝病，在南亚地区的发病率也在惊人地上升，由于过去二十年南亚年轻人中肥胖症和代谢综合征（MS）的流行，其发病率达到了30%的流行比例。在印度、巴基斯坦、斯里兰卡、孟加拉国、尼泊尔、不丹、缅甸和马尔代夫等南亚国家，由于久坐不动的生活方式、健康意识淡薄、社会经济增长、富裕程度提高、城市化进程以及饮食西化，MS和脂肪肝的患病率呈几何级数上升。世界上近20%的人口居住在南亚，使其成为世界上人口最多、人口密度最大的地理区域，因此该地区境内有大多数MS和NAFLD病例。南亚人与其他种族人群在NAFLD的危险因素和病程方面并无差异，但肥胖症在南亚的流行比世界其他地区更为近期。非酒精性脂肪性肝病可能会经历单纯性脂肪肝、非酒精性脂肪性肝炎（NASH）、肝纤维化、肝硬化，最终发展为肝细胞癌（HCC）等阶段。它常与肥胖症、MS、血脂异常、胰岛素抵抗（IR）和2型糖尿病（DM）相关。非酒精性脂肪性肝病常通过腹部超声（US）检查来诊断。尽管到目前为止其在社区中的患病率很高，但尚无针对NAFLD的确切药物治疗方法。然而，改变诸如血脂异常等危险因素、控制糖尿病以及减轻体重在一定程度上确实有所帮助。非肥胖的南亚人患NAFLD和NASH的风险也有所增加，因为尽管南亚人没有明显的肥胖症，但与其他种族人群相比，他们在代谢上更肥胖，更容易发生与NAFLD相关的并发症。因此，在这个资源有限的南亚地区，成本效益高的腹部超声检查应纳入就业前或全面健康检查的人员检测项目清单中，以便能够尽早采取必要措施，降低社区中与NAFLD相关的发病率和死亡率。
帕蒂GK，辛格SP。南亚的非酒精性脂肪性肝病。《欧亚肝脏胃肠病学杂志》2016年；6（2）：154 - 162。
