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非糖尿病性内分泌疾病中的非酒精性脂肪性肝炎

NASH in Nondiabetic Endocrine Disorders.

作者信息

Wang Timothy, Yang Wei, Karakas Sidika, Sarkar Souvik

机构信息

1 Department of Internal Medicine, University of California , Davis, Sacramento, California.

2 Division of Endocrinology, University of California , Davis, Sacramento, California.

出版信息

Metab Syndr Relat Disord. 2018 Sep;16(7):315-320. doi: 10.1089/met.2018.0044. Epub 2018 Jun 6.

Abstract

Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of disease, including hepatic steatosis, inflammation, and fibrosis. NAFLD carries the risk of progression to cirrhosis with its associated complications and hepatocellular carcinoma. It is now the most common liver disease in the Western world and its prevalence is increasing. While the association between NAFLD and type 2 diabetes has been well documented, there is significantly less understanding of the pathophysiology and progression of NAFLD in patients with other endocrine disorders affecting metabolism in various ways. Some of the more common endocrine disorders such as polycystic ovarian syndrome, growth hormone deficiency, hypothyroidism, and hypogonadism are known in clinical practice to be associated with NAFLD. Medications that alter the endocrine system such as tamoxifen and adrenal steroids have also been attributed to significant NAFLD. The key to management of NAFLD at this time are dietary changes and exercise to achieve weight loss. Unfortunately, a large proportion of the patients with these endocrine disorders are unable to achieve either. This review aims to examine and summarize the current published literature that have evaluated the association between NAFLD and the above endocrine disorders and potential therapeutic interventions in each case.

摘要

非酒精性脂肪性肝病(NAFLD)涵盖一系列疾病,包括肝脂肪变性、炎症和纤维化。NAFLD有进展为肝硬化及其相关并发症和肝细胞癌的风险。它现已成为西方世界最常见的肝脏疾病,且患病率正在上升。虽然NAFLD与2型糖尿病之间的关联已有充分记录,但对于以各种方式影响代谢的其他内分泌疾病患者中NAFLD的病理生理学和进展的了解却少得多。临床实践中已知一些较常见的内分泌疾病,如多囊卵巢综合征、生长激素缺乏症、甲状腺功能减退症和性腺功能减退症与NAFLD有关。改变内分泌系统的药物,如他莫昔芬和肾上腺类固醇,也被认为与严重的NAFLD有关。目前NAFLD管理的关键是通过饮食改变和运动来实现体重减轻。不幸的是,这些内分泌疾病的很大一部分患者无法做到这两点。本综述旨在检查和总结当前已发表的文献,这些文献评估了NAFLD与上述内分泌疾病之间的关联以及每种情况下的潜在治疗干预措施。

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