Chen H T, Zhou Y J
Department of Gastroenterology and Hepatology, Guangzhou First People's Hospital, Guangzhou Digestive Disease Center, School of Medicine, South China University of Technology, Guangzhou 510180, China.
Zhonghua Gan Zang Bing Za Zhi. 2020 Mar 20;28(3):203-207. doi: 10.3760/cma.j.cn501113-20191226-00480.
Non-alcoholic fatty liver disease and obesity have interconnected genes, but it can also occur in non-obese population with body mass index < 25 kg/m(2). Non-obese type of non-alcoholic fatty liver disease mostly occurs in Asia. There is no significant difference between obese and non-obese type of non-alcoholic fatty liver in histological examination of liver biopsies. Visceral obesity, high fructose and cholesterol intake, and genetic factors such as APOC3 gene mutation are closely related to non-obese type of non-alcoholic fatty liver. Generally speaking, non-alcoholic steatohepatitis has an increased mortality rate, mainly due to cardiovascular causes, and has no link with other metabolic factors. Although data on the impact of mortality from non-obese type of non-alcoholic fatty liver disease are incomplete and limited, however diagnosis, management, and treatment may be important. Lifestyle changes to reduce visceral obesity, including dietary changes and physical activity, remain the main treatment options for patients with non-obese type of non-alcoholic fatty liver disease.
非酒精性脂肪性肝病与肥胖症存在相互关联的基因,但在体重指数<25kg/m²的非肥胖人群中也可能发生。非肥胖型非酒精性脂肪性肝病多见于亚洲。在肝活检的组织学检查中,肥胖型和非肥胖型非酒精性脂肪性肝病之间没有显著差异。内脏肥胖、高果糖和胆固醇摄入以及诸如载脂蛋白C3基因突变等遗传因素与非肥胖型非酒精性脂肪性肝病密切相关。一般来说,非酒精性脂肪性肝炎的死亡率有所上升,主要是心血管原因导致的,且与其他代谢因素无关。尽管关于非肥胖型非酒精性脂肪性肝病死亡率影响的数据并不完整且有限,但诊断、管理和治疗可能很重要。改变生活方式以减少内脏肥胖,包括饮食改变和体育活动,仍然是非肥胖型非酒精性脂肪性肝病患者的主要治疗选择。