Negro Francesco
Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospitals, Geneva, Switzerland.
Liver Int. 2020 Feb;40 Suppl 1:72-76. doi: 10.1111/liv.14362.
Widespread unhealthy dietary habits associated with a sedentary lifestyle have made NAFLD the most frequent chronic liver disease worldwide, with a global prevalence of ~25%. Although NAFLD is mainly considered to be a benign disease, it can progress to severe liver fibrosis and hepatocellular carcinoma (HCC), with the latter found in non-cirrhotic livers in about 40% of cases. Factors favouring the progression of liver disease in NAFLD are only partially understood. Male sex, older age and Caucasian ethnicity have frequently been identified as factors accelerating the progression of fibrosis in NAFLD, although data are not consistent. Host genetic variants appear to be very important, especially in the gene coding for the patatin-like phospholipase domain-containing 3 (PNPLA3), and they may also play a role in the development of HCC, independent of activity and the extent of liver damage. However, the most important factors affecting disease progression are found in the metabolic syndrome, that is, obesity, type 2 diabetes and arterial hypertension. This mini-review will discuss the contribution of these factors to NAFLD-associated morbidity, emphasizing the importance of preventive measures such as physical activity and weight control in view of the current pandemic of the metabolic syndrome.
与久坐不动的生活方式相关的广泛存在的不健康饮食习惯，已使非酒精性脂肪性肝病（NAFLD）成为全球最常见的慢性肝病，全球患病率约为25%。尽管NAFLD主要被认为是一种良性疾病，但它可进展为严重肝纤维化和肝细胞癌（HCC），约40%的病例在非肝硬化肝脏中发现后者。NAFLD中有利于肝病进展的因素仅得到部分理解。男性、老年和白种人常被确定为加速NAFLD纤维化进展的因素，尽管数据并不一致。宿主基因变异似乎非常重要，尤其是在编码含帕他汀样磷脂酶结构域3（PNPLA3）的基因中，并且它们可能在HCC的发生发展中也起作用，独立于肝脏损伤的活动度和程度。然而，影响疾病进展的最重要因素存在于代谢综合征中，即肥胖、2型糖尿病和动脉高血压。本综述将讨论这些因素对NAFLD相关发病率的影响，鉴于当前代谢综合征的流行，强调诸如体育活动和体重控制等预防措施的重要性。
