Sanai Faisal M, Abaalkhail Faisal, Hasan Fuad, Farooqi Muhammad Hamed, Nahdi Nawal Al, Younossi Zobair M
Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia.
Department of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.
World J Gastroenterol. 2020 Jul 7;26(25):3528-3541. doi: 10.3748/wjg.v26.i25.3528.
The prevalence of nonalcoholic fatty liver disease (NAFLD) in the Middle East is increasing in parallel to an increase in the prevalence of associated risk factors such as obesity, metabolic syndrome, and type 2 diabetes mellitus. About 20% to 30% of the patients progress to develop nonalcoholic steatohepatitis (NASH), a histological subtype of NAFLD, with features of hepatocyte injury such as hepatocyte ballooning. NASH can progress to fibrosis, cirrhosis, and even hepatocellular carcinoma. NAFLD thus causes a substantial burden on healthcare systems and it is imperative that appropriate strategies are discussed at a regional level to facilitate effective management tailored to the needs of the region. To fulfil this unmet need, expert gastroenterologists, hepatologists, and endocrinologists from the region came together in three advisory board meetings that were conducted in Saudi Arabia, United Arab Emirates, and Kuwait, to discuss current local challenges in NAFLD screening and diagnosis, and the different available management options. The experts discussed the disease burden of NAFLD/NASH in the Middle East; screening, diagnosis, and referral patterns in NAFLD; and available treatment options for NAFLD and NASH. This paper summarizes the discussions and opinion of the expert panel on the management of NAFLD/NASH and also presents an extensive literature review on the topic.
中东地区非酒精性脂肪性肝病（NAFLD）的患病率随着肥胖、代谢综合征和2型糖尿病等相关危险因素患病率的上升而增加。约20%至30%的患者会进展为非酒精性脂肪性肝炎（NASH），这是NAFLD的一种组织学亚型，具有肝细胞损伤的特征，如肝细胞气球样变。NASH可进展为纤维化、肝硬化，甚至肝细胞癌。因此，NAFLD给医疗系统带来了沉重负担，当务之急是在区域层面讨论适当的策略，以促进根据该地区需求进行有效管理。为满足这一未得到满足的需求，该地区的专家胃肠病学家、肝病学家和内分泌学家齐聚在沙特阿拉伯、阿拉伯联合酋长国和科威特举行的三次咨询委员会会议上，讨论NAFLD筛查和诊断方面当前的当地挑战以及不同的可用管理方案。专家们讨论了中东地区NAFLD/NASH的疾病负担；NAFLD的筛查、诊断和转诊模式；以及NAFLD和NASH的可用治疗方案。本文总结了专家小组对NAFLD/NASH管理的讨论和意见，并对该主题进行了广泛的文献综述。
