Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
Nutrition and Metabolism, Faculty of Medicine, University of Southampton, UK; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Tremona Road, Southampton, UK; Department of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
Metabolism. 2020 Oct;111S:154170. doi: 10.1016/j.metabol.2020.154170. Epub 2020 Jan 30.
Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized public health problem, affecting up to a quarter of the world's adult population. The burden of NAFLD is influenced by the epidemics of obesity and type 2 diabetes mellitus (T2DM) and the prevalence of these conditions is not expected to decrease in the forthcoming decades. Consequently, the burden of NAFLD-related liver complications (non-alcoholic steatohepatitis [NASH], cirrhosis and hepatocellular carcinoma) and the need for life-saving liver transplantation are also expected to increase further in the near future. A large body of clinical evidence indicates that NAFLD is associated not only with increased liver-related morbidity and mortality, but also with an increased risk of developing other important extra-hepatic diseases, such as cardiovascular disease (that is the predominant cause of death in patients with NAFLD), extra-hepatic cancers (mainly colorectal cancers), T2DM and chronic kidney disease. Thus, NAFLD creates a considerable health and economic burden worldwide and often results in poor quality of life. This narrative review provides an overview of the current literature on main complications, morbidity and mortality of this common and burdensome liver disease.
非酒精性脂肪性肝病（NAFLD）是一个日益受到关注的公共卫生问题，影响了全球多达四分之一的成年人口。NAFLD 的负担受到肥胖和 2 型糖尿病（T2DM）流行的影响，预计在未来几十年这些疾病的患病率不会下降。因此，NAFLD 相关的肝脏并发症（非酒精性脂肪性肝炎[NASH]、肝硬化和肝细胞癌）的负担以及需要进行挽救生命的肝移植的需求也预计将在不久的将来进一步增加。大量临床证据表明，NAFLD 不仅与肝脏相关发病率和死亡率的增加有关，而且还与发生其他重要的肝外疾病的风险增加有关，如心血管疾病（这是 NAFLD 患者的主要死亡原因）、肝外癌症（主要是结直肠癌）、T2DM 和慢性肾脏病。因此，NAFLD 在全球范围内造成了相当大的健康和经济负担，并常常导致生活质量下降。本综述概述了关于这种常见且负担沉重的肝脏疾病的主要并发症、发病率和死亡率的当前文献。
