Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
Institute of Pathology, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
J Hepatol. 2021 Jun;74(6):1455-1471. doi: 10.1016/j.jhep.2021.01.045. Epub 2021 Feb 10.
The term non-alcoholic fatty liver disease (NAFLD) was originally coined to describe hepatic fat deposition as part of the metabolic syndrome. However, a variety of rare hereditary liver and metabolic diseases, intestinal diseases, endocrine disorders and drugs may underlie, mimic, or aggravate NAFLD. In contrast to primary NAFLD, therapeutic interventions are available for many secondary causes of NAFLD. Accordingly, secondary causes of fatty liver disease should be considered during the diagnostic workup of patients with fatty liver disease, and treatment of the underlying disease should be started to halt disease progression. Common genetic variants in several genes involved in lipid handling and metabolism modulate the risk of progression from steatosis to fibrosis, cirrhosis and hepatocellular carcinoma development in NAFLD, alcohol-related liver disease and viral hepatitis. Hence, we speculate that genotyping of common risk variants for liver disease progression may be equally useful to gauge the likelihood of developing advanced liver disease in patients with secondary fatty liver disease.
非酒精性脂肪性肝病（NAFLD）一词最初是用来描述肝脏脂肪沉积作为代谢综合征的一部分。然而，各种罕见的遗传性肝脏和代谢疾病、肠道疾病、内分泌紊乱和药物可能是 NAFLD 的基础、模仿或加重因素。与原发性 NAFLD 不同，许多继发性 NAFLD 的病因都有治疗干预措施。因此，在对脂肪肝患者进行诊断时应考虑脂肪性肝病的继发性病因，应开始治疗基础疾病以阻止疾病进展。涉及脂质处理和代谢的几个基因中的常见遗传变异可调节从脂肪变性进展为纤维化、肝硬化和肝细胞癌的风险，在 NAFLD、酒精性肝病和病毒性肝炎中也是如此。因此，我们推测，对肝脏疾病进展的常见风险变异进行基因分型，对于评估继发性脂肪性肝病患者发生晚期肝病的可能性可能同样有用。
