Department of Endocrinology and Nutrition, Healthcare Research Institute of Navarra (IdiSNA), University of Navarra, Navarra, Spain
Hepatology, PROMISE (Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza), University of Palermo, Palermo, Italy
Pol Arch Intern Med. 2020 Nov 30;130(11):975-985. doi: 10.20452/pamw.15510. Epub 2020 Jul 14.
Nonalcoholic fatty liver disease (NAFLD) is a clinical condition that encompasses various forms of liver damage not caused by chronic alcohol consumption. In the absence of other etiologies, it ranges from steatosis to nonalcoholic steatohepatitis and cirrhosis. The prevalence of NAFLD has considerably increased over the last years owing to the current lifestyle (unhealthy diet and sedentarism). Besides, it is associated with metabolic risk factors such as obesity, arterial hypertension, dyslipidemia, and type 2 diabetes. Given the poor prognosis of patients with advanced NAFLD, a practical therapeutic approach is necessary to halt its natural history. However, no licensed drugs have been approved for this purpose to date. Nowadays, we are in a race to find the first drug able to stop the incidence of NAFLD and reverse the disease in patients at more advanced stages. Meanwhile, the management of the NAFLD metabolic overload, including weight loss, cardiovascular protection, insulin sensitization, and lipid reduction, is the only strategy to improve hepatic and extrahepatic outcomes. In this review, we aimed to describe the management of the main metabolic disorders related to NAFLD, such as type 2 diabetes, arterial hypertension, and dyslipidemia.
非酒精性脂肪性肝病（NAFLD）是一种临床病症，涵盖了各种非慢性酒精性肝损伤形式。在没有其他病因的情况下，它的范围从脂肪变性到非酒精性脂肪性肝炎和肝硬化。由于当前的生活方式（不健康的饮食和久坐不动），NAFLD 的患病率在过去几年中显著增加。此外，它与代谢风险因素如肥胖、动脉高血压、血脂异常和 2 型糖尿病有关。鉴于晚期 NAFLD 患者的预后不佳，需要采取实用的治疗方法来阻止其自然病程。然而，迄今为止，尚无获准用于该目的的药物。如今，我们正在竞相寻找第一种能够阻止 NAFLD 发病率并在更晚期患者中逆转疾病的药物。同时，NAFLD 代谢超负荷的管理，包括减肥、心血管保护、胰岛素增敏和降低血脂，是改善肝内和肝外结果的唯一策略。在这篇综述中，我们旨在描述与 NAFLD 相关的主要代谢紊乱的管理，如 2 型糖尿病、动脉高血压和血脂异常。
