Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Jacksonville, FL, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Clin Mol Hepatol. 2021 Apr;27(2):221-235. doi: 10.3350/cmh.2020.0239. Epub 2020 Dec 3.
Nonalcoholic fatty liver disease (NAFLD) is a multisystemic disease and a rapidly growing cause of chronic liver disease in children and adults worldwide. Diagnosis and management of extrahepatic manifestations of NAFLD, including cardiovascular disease (CVD), type 2 diabetes mellitus, metabolic syndrome, chronic kidney disease, obstructive sleep apnea, polycystic ovarian syndrome, hypothyroidism, psoriasis, and extrahepatic malignancy are crucial for the treatment of patients with NAFLD. The leading cause of death in NAFLD is primarily from CVD, followed by liver-related mortality, extrahepatic cancer, liver cancer, and diabetes-related mortality. Therefore, clinicians need to identify high-risk patients earlier in the disease course and be aware of the extrahepatic manifestations of NAFLD to improve liver disease outcomes. In this review, we focus on the monitoring and management of the extrahepatic manifestations of NAFLD.
非酒精性脂肪性肝病（NAFLD）是一种多系统疾病，也是全球儿童和成人慢性肝病的一个快速增长的病因。NAFLD 的肝外表现，包括心血管疾病（CVD）、2 型糖尿病、代谢综合征、慢性肾脏病、阻塞性睡眠呼吸暂停、多囊卵巢综合征、甲状腺功能减退症、银屑病和肝外恶性肿瘤的诊断和治疗，对于 NAFLD 患者的治疗至关重要。NAFLD 患者的主要死亡原因主要来自 CVD，其次是与肝脏相关的死亡率、肝外癌症、肝癌和糖尿病相关的死亡率。因此，临床医生需要在疾病早期识别高危患者，并了解 NAFLD 的肝外表现，以改善肝病结局。在本综述中，我们重点关注 NAFLD 肝外表现的监测和管理。
