Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Organization of African Unity Street, Abbasia, Cairo 11566, Egypt.
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Organization of African Unity Street, Abbasia, Cairo 11566, Egypt.
Life Sci. 2021 Apr 15;271:119220. doi: 10.1016/j.lfs.2021.119220. Epub 2021 Feb 13.
Non-alcoholic fatty liver disease (NAFLD) is a disorder of excessive fat accumulation in the liver, known as steatosis, without alcohol overconsumption. NAFLD can either manifest as simple steatosis or steatohepatitis, known as non-alcoholic steatohepatitis (NASH), which is accompanied by inflammation and possibly fibrosis. Furthermore, NASH might progress to hepatocellular carcinoma. NAFLD and NASH prevalence is in a continuous state of growth, and by 2018, NAFLD became a devastating metabolic disease with a global pandemic prevalence. The pathophysiology of NAFLD and NASH is not fully elucidated, but is known to involve the complex interplay between different metabolic, environmental, and genetic factors. In addition, unhealthy dietary habits and pre-existing metabolic disturbances together with other risk factors predispose NAFLD development and progression from simple steatosis to steatohepatitis, and eventually to fibrosis. Despite their growing worldwide prevalence, to date, there is no FDA-approved treatment for NAFLD and NASH. Several off-label medications are used to target disease risk factors such as obesity and insulin resistance, and some medications are used for their hepatoprotective effects. Unfortunately, currently used medications are not sufficiently effective, and research is ongoing to investigate the beneficial effects of different drugs and phytochemicals in NASH. In this review article, we outline the different risk factors and pathophysiological mechanisms involved in NAFLD, diagnostic procedures, and currently used management techniques.
非酒精性脂肪性肝病（NAFLD）是一种肝脏内脂肪过度积累的疾病，称为脂肪变性，不伴有酒精过度摄入。NAFLD 可以表现为单纯性脂肪变性或脂肪性肝炎，称为非酒精性脂肪性肝炎（NASH），伴有炎症和可能的纤维化。此外，NASH 可能进展为肝细胞癌。NAFLD 和 NASH 的患病率呈持续增长趋势，到 2018 年，NAFLD 已成为一种具有全球流行患病率的破坏性代谢疾病。NAFLD 和 NASH 的病理生理学尚未完全阐明，但已知涉及不同代谢、环境和遗传因素的复杂相互作用。此外，不健康的饮食习惯和预先存在的代谢紊乱以及其他风险因素导致 NAFLD 从单纯性脂肪变性发展为脂肪性肝炎，并最终发展为纤维化。尽管它们在全球的患病率不断增长，但迄今为止，还没有获得 FDA 批准的 NAFLD 和 NASH 治疗方法。一些非适应证药物被用于针对肥胖和胰岛素抵抗等疾病风险因素，一些药物则用于其肝脏保护作用。不幸的是，目前使用的药物效果并不足够，并且正在研究不同药物和植物化学物质在 NASH 中的有益作用。在这篇综述文章中，我们概述了 NAFLD 涉及的不同风险因素和病理生理学机制、诊断程序以及目前使用的管理技术。
