Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Gut Liver. 2020 Mar 15;14(2):168-178. doi: 10.5009/gnl19069.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and encompasses a spectrum of pathology from simple steatosis to inflammation and significant fibrosis that leads to cirrhosis. NAFLD and its comorbid conditions extend well beyond the liver. It is a multisystemic clinical disease entity with extrahepatic manifestations such as cardiovascular disease, type 2 diabetes, chronic kidney disease, hypothyroidism, polycystic ovarian syndrome, and psoriasis. Indeed, the most common causes of mortality in subjects with NAFLD are cardiovascular disease, followed by malignancies and then liver-related complications as a distant third. This review focuses on several of the key extrahepatic manifestations of NAFLD and areas for future investigation. Clinicians should learn to screen and initiate treatment for these extrahepatic manifestations in a prompt and timely fashion before they progress to end-organ damage.
非酒精性脂肪性肝病(NAFLD)是最常见的慢性肝病,涵盖了从单纯脂肪变性到炎症和显著纤维化导致肝硬化的一系列病理学改变。NAFLD 及其合并症不仅局限于肝脏,它还是一种全身性的临床疾病实体,具有肝外表现,如心血管疾病、2 型糖尿病、慢性肾脏病、甲状腺功能减退症、多囊卵巢综合征和银屑病。事实上,NAFLD 患者最常见的死亡原因是心血管疾病,其次是恶性肿瘤,然后是肝脏相关并发症,位列第三。本综述重点介绍了 NAFLD 的几种主要肝外表现和未来的研究领域。临床医生应该学会及时筛查和治疗这些肝外表现,以防止其进展为终末器官损害。
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