Department of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands.
Department of Vascular Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.
Eur J Endocrinol. 2020 Sep;183(3):R57-R73. doi: 10.1530/EJE-20-0065.
Non-alcoholic fatty liver disease (NAFLD) is a growing health problem with a global prevalence of over 25% and prevalence rates of over 60% in high-risk populations. It is considered the hepatic component of the metabolic syndrome and is associated with an increased risk of the development of various liver-associated and cardiometabolic complications. Given the complexity of NAFLD and associated comorbidities and complications, treatment requires interventions from a variety of different healthcare specialties. However, many clinicians are currently insufficiently aware of the potential harm and severity of NAFLD and associated comorbidities, complications and the steps that should be taken when NAFLD is suspected. Recognizing which patients suffer from non-progressive simple steatosis, metabolically active NASH with high risk of developing cardiovascular disease and which patients have a high risk of developing cirrhosis and hepatocellular carcinoma is important. Unfortunately, this can be difficult and guidelines towards the optimal diagnostic and therapeutic approach are ambivalent. Here we review the pathogenesis, diagnostics and treatment of NAFLD and discuss how multidisciplinary care path development could move forward.
非酒精性脂肪性肝病（NAFLD）是一个日益严重的健康问题，全球患病率超过 25%，高危人群的患病率超过 60%。它被认为是代谢综合征的肝组分，与各种与肝相关和心脏代谢并发症的发展风险增加相关。鉴于 NAFLD 及其相关合并症和并发症的复杂性，治疗需要来自各种不同医疗保健专业的干预。然而，目前许多临床医生对 NAFLD 及其相关合并症、并发症的潜在危害和严重程度以及怀疑 NAFLD 时应采取的步骤认识不足。认识到哪些患者患有非进展性单纯性脂肪变性、代谢活跃的 NASH，其发生心血管疾病的风险较高，以及哪些患者发生肝硬化和肝细胞癌的风险较高是很重要的。不幸的是，这可能很困难，并且针对最佳诊断和治疗方法的指南存在矛盾。在这里，我们回顾了 NAFLD 的发病机制、诊断和治疗，并讨论了多学科护理路径的发展如何能够取得进展。
