Department of Medicine, College of Medicine, Drexel University, Philadelphia, PA 19129, United States.
Division of Gastroenterology and Hepatology, Health Science Center, University of Tennessee, Memphis, TN 38163, United States.
World J Gastroenterol. 2017 Dec 21;23(47):8263-8276. doi: 10.3748/wjg.v23.i47.8263.
Nonalcoholic fatty liver disease (NAFLD) is defined as the presence of hepatic fat accumulation after the exclusion of other causes of hepatic steatosis, including other causes of liver disease, excessive alcohol consumption, and other conditions that may lead to hepatic steatosis. NAFLD encompasses a broad clinical spectrum ranging from nonalcoholic fatty liver to nonalcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis, and finally hepatocellular carcinoma (HCC). NAFLD is the most common liver disease in the world and NASH may soon become the most common indication for liver transplantation. Ongoing persistence of obesity with increasing rate of diabetes will increase the prevalence of NAFLD, and as this population ages, many will develop cirrhosis and end-stage liver disease. There has been a general increase in the prevalence of NAFLD, with Asia leading the rise, yet the United States is following closely behind with a rising prevalence from 15% in 2005 to 25% within 5 years. NAFLD is commonly associated with metabolic comorbidities, including obesity, type II diabetes, dyslipidemia, and metabolic syndrome. Our understanding of the pathophysiology of NAFLD is constantly evolving. Based on NAFLD subtypes, it has the potential to progress into advanced fibrosis, end-stage liver disease and HCC. The increasing prevalence of NAFLD with advanced fibrosis, is concerning because patients appear to experience higher liver-related and non-liver-related mortality than the general population. The increased morbidity and mortality, healthcare costs and declining health related quality of life associated with NAFLD makes it a formidable disease, and one that requires more in-depth analysis.
非酒精性脂肪性肝病（NAFLD）是指在排除其他原因引起的肝脂肪变性后，肝脏脂肪积聚的存在，包括其他肝病、过量饮酒和其他可能导致肝脂肪变性的情况。NAFLD 涵盖了广泛的临床谱，从非酒精性脂肪肝到非酒精性脂肪性肝炎（NASH）、进展性肝纤维化、肝硬化，最终发展为肝细胞癌（HCC）。NAFLD 是世界上最常见的肝脏疾病，NASH 可能很快成为肝移植最常见的适应证。随着肥胖率的不断增加和糖尿病的发生率不断上升，NAFLD 的患病率将会增加，随着这一人群的老龄化，许多人将发展为肝硬化和终末期肝病。NAFLD 的患病率普遍上升，亚洲处于领先地位，而美国紧随其后，患病率从 2005 年的 15%上升到 5 年内的 25%。NAFLD 通常与代谢合并症相关，包括肥胖、2 型糖尿病、血脂异常和代谢综合征。我们对 NAFLD 病理生理学的理解在不断发展。根据 NAFLD 亚型，它有可能进展为晚期纤维化、终末期肝病和 HCC。NAFLD 合并晚期纤维化的患病率不断上升，令人担忧的是，与一般人群相比，患者似乎经历更高的与肝脏相关和非肝脏相关的死亡率。NAFLD 相关的发病率、死亡率增加、医疗保健费用和健康相关生活质量下降，使其成为一种严重的疾病，需要更深入的分析。
