Ekstedt Mattias, Nasr Patrik, Kechagias Stergios
Department of Gastroenterology and Hepatology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Curr Hepatol Rep. 2017;16(4):391-397. doi: 10.1007/s11901-017-0378-2. Epub 2017 Nov 13.
The purpose of this review is to summarize the latest knowledge on the natural history of non-alcoholic fatty liver disease (NAFLD). The review focuses on mortality, liver-related complications, and histological course.
Studies during the last decade have established NAFLD as a potentially progressive liver disease. Age and diabetes are the strongest clinical predictors of progressive disease. Fibrosis stage is the most important histological variable to predict mortality and liver-related complications. So far, no study has been able to show that non-alcoholic steatohepatitis at baseline predicts mortality or future liver-related complications when adjusting for fibrosis.
The outlines of the natural history of NAFLD have become clearer during the last decade. There is limited data on factors that predict clinical progression. Prospective longitudinal studies are needed to help us predict worse outcome in individual patients.
本综述旨在总结非酒精性脂肪性肝病（NAFLD）自然史的最新知识。该综述聚焦于死亡率、肝脏相关并发症及组织学病程。
过去十年的研究已证实NAFLD是一种潜在进展性肝病。年龄和糖尿病是疾病进展最强的临床预测因素。纤维化阶段是预测死亡率和肝脏相关并发症最重要的组织学变量。迄今为止，尚无研究能够表明，在校正纤维化因素后，基线时的非酒精性脂肪性肝炎可预测死亡率或未来肝脏相关并发症。
在过去十年中，NAFLD自然史的轮廓已变得更加清晰。预测临床进展的因素数据有限。需要开展前瞻性纵向研究，以帮助我们预测个体患者的不良结局。
