Pais Raluca, Maurel Thomas
Institut de Cardiométabolisme et Nutrition, Hôpital Pitié Salpetrière, Assistance Publique Hôpitaux de Paris, 75013 Paris, France.
J Clin Med. 2021 Mar 10;10(6):1161. doi: 10.3390/jcm10061161.
The epidemiology and the current burden of chronic liver disease are changing globally, with non-alcoholic fatty liver disease (NAFLD) becoming the most frequent cause of liver disease in close relationship with the global epidemics of obesity, type 2 diabetes and metabolic syndrome. The clinical phenotypes of NAFLD are very heterogeneous in relationship with multiple pathways involved in the disease progression. In the absence of a specific treatment for non-alcoholic steatohepatitis (NASH), it is important to understand the natural history of the disease, to identify and to optimize the control of factors that are involved in disease progression. In this paper we propose a critical analysis of factors that are involved in the progression of the liver damage and the occurrence of extra-hepatic complications (cardiovascular diseases, extra hepatic cancer) in patients with NAFLD. We also briefly discuss the impact of the heterogeneity of the clinical phenotype of NAFLD on the clinical practice globally and at the individual level.
全球慢性肝病的流行病学和当前负担正在发生变化，非酒精性脂肪性肝病（NAFLD）成为与全球肥胖、2型糖尿病和代谢综合征流行密切相关的最常见肝病病因。NAFLD的临床表型因疾病进展涉及的多种途径而非常异质。在缺乏非酒精性脂肪性肝炎（NASH）特异性治疗方法的情况下，了解疾病的自然史、识别并优化对疾病进展相关因素的控制非常重要。在本文中，我们对NAFLD患者肝损伤进展及肝外并发症（心血管疾病、肝外癌症）发生的相关因素进行批判性分析。我们还简要讨论了NAFLD临床表型异质性对全球及个体临床实践的影响。
