Department of Medicine, Hospital Universiti Sains Malaysia, Jalan Raja Perempuan, Zainab II1, 6150 Kota Bharu, Kelantan, Malaysia, Email:
Gastroenterology Division, Department of Medicine, Hospital Universiti Sains Malaysia.
J R Coll Physicians Edinb. 2020 Sep;50(3):256-261. doi: 10.4997/JRCPE.2020.308.
Globally, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing rapidly and constitutes a significant healthcare burden due to associated complications including hepatic (cirrhosis and hepatocellular cancer) and non-hepatic (cardiovascular deaths) disorders. It is closely linked to insulin resistance and metabolic syndrome but moderate alcohol consumption frequently coexists. Recently, genetic polymorphisms were implicated in the development of non-obese NAFLD. Apart from liver biopsy, in order to assess for steatosis, fibrosis and non-alcoholic steatohepatitis (NASH), advances in non-invasive serum tests and elastography have provided similarly accurate, more accessible and safer alternatives for risk stratification. As for treatment in 2020, weight loss and lifestyle modification remain the central strategy. Unfortunately, no pharmacological agents have been approved thus far, but there are a number of potential therapies in the pipeline for fibrosis and NASH. Treatment of underlying metabolic disorders is important. While the term NAFLD was coined in the 1980s, more recent understanding may support a change in nomenclature highlighting its strong metabolic roots.
全球范围内，非酒精性脂肪性肝病（NAFLD）的患病率正在迅速上升，由于相关并发症（包括肝脏疾病[肝硬化和肝细胞癌]和非肝脏疾病[心血管死亡]），该病给医疗保健带来了重大负担。它与胰岛素抵抗和代谢综合征密切相关，但也常与适量饮酒并存。最近，遗传多态性被认为与非肥胖型 NAFLD 的发生有关。除了肝活检，为了评估脂肪变性、纤维化和非酒精性脂肪性肝炎（NASH），非侵入性血清检测和弹性成像的进展为风险分层提供了同样准确、更易获得和更安全的替代方法。至于 2020 年的治疗方法，减轻体重和生活方式改变仍然是核心策略。不幸的是，迄今为止尚未批准任何药物治疗，但针对纤维化和 NASH 有许多潜在的治疗方法正在研发中。治疗潜在的代谢紊乱也很重要。虽然 20 世纪 80 年代就提出了 NAFLD 这一术语，但最近的认识可能支持改变命名法，突出其强烈的代谢根源。
