Altamirano Jose, Qi Qiaochu, Choudhry Sabina, Abdallah Mohamed, Singal Ashwani K, Humar Abhinav, Bataller Ramón, Borhani Amir Ali, Duarte-Rojo Andrés
Department of Internal Medicine (Hepatology Section), Hospital Quironsalud Barcelona, Spain.
Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Transl Gastroenterol Hepatol. 2020 Apr 5;5:31. doi: 10.21037/tgh.2019.11.14. eCollection 2020.
Non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) are becoming the leading causes of chronic liver disease worldwide, significantly impacting public health and healthcare cost. The development of fibrosis is the main factor leading to early mortality and morbidity in NAFLD and ALD. Thus, it is important to timely and reliably evaluate these diseases at early stages, when fibrosis is not advanced or when steatosis predominates. Liver biopsy has been the standard of reference for fibrosis and steatosis, however, its invasiveness precludes its widespread use. There is growing research on non-invasive methods for diagnosing and stratifying fibrosis and steatosis in NAFLD and ALD. This review presents clinical evidence on the use of non-invasive assessment of liver disease (blood-based and imaging-based) in patients with NALFD and ALD, and proposes algorithms incorporating these tests into their management.
非酒精性脂肪性肝病（NAFLD）和酒精性肝病（ALD）正成为全球慢性肝病的主要病因，对公众健康和医疗成本产生重大影响。纤维化的发展是导致NAFLD和ALD早期死亡率和发病率的主要因素。因此，在纤维化未进展或脂肪变性占主导的早期阶段及时、可靠地评估这些疾病非常重要。肝活检一直是纤维化和脂肪变性的参考标准，然而，其侵入性使其无法广泛应用。关于NAFLD和ALD中纤维化和脂肪变性的诊断及分层的非侵入性方法的研究越来越多。本综述介绍了在NALFD和ALD患者中使用非侵入性肝病评估（基于血液和基于影像）的临床证据，并提出了将这些检测纳入其管理的算法。
