Kanwal Fasiha, Shubrook Jay H, Younossi Zobair, Natarajan Yamini, Bugianesi Elisabetta, Rinella Mary E, Harrison Stephen A, Mantzoros Christos, Pfotenhauer Kim, Klein Samuel, Eckel Robert H, Kruger Davida, El-Serag Hashem, Cusi Kenneth
Baylor College of Medicine, Veterans Affairs Health Services Research and Development Service, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States of America.
Touro University California, College of Osteopathic Medicine, Vallejo, CA, United States of America.
Metabolism. 2021 Sep;122:154822. doi: 10.1016/j.metabol.2021.154822. Epub 2021 Jul 19.
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are common conditions with a rising burden. Yet there are significant management gaps between clinical guidelines and practice in patients with NAFLD and NASH. Further, there is no single global guiding strategy for the management of NAFLD and NASH. The American Gastroenterological Association, in collaboration with 7 professional associations, convened an international conference comprising 32 experts in gastroenterology, hepatology, endocrinology, and primary care providers from the United States, Europe, Asia, and Australia. Conference content was informed by the results of a national NASH Needs Assessment Survey. The participants reviewed and discussed published literature on global burden, screening, risk stratification, diagnosis, and management of individuals with NAFLD, including those with NASH. Participants identified promising approaches for clinical practice and prepared a comprehensive, unified strategy for primary care providers and relevant specialists encompassing the full spectrum of NAFLD/NASH care. They also identified specific high-yield targets for clinical research and called for a unified, international public health response to NAFLD and NASH.
非酒精性脂肪性肝病(NAFLD)和非酒精性脂肪性肝炎(NASH)是负担日益加重的常见病症。然而,NAFLD和NASH患者的临床指南与实际治疗之间存在显著差距。此外,对于NAFLD和NASH的管理,尚无单一的全球指导策略。美国胃肠病学会与7个专业协会合作,召开了一次国际会议,参会人员包括来自美国、欧洲、亚洲和澳大利亚的32位胃肠病学、肝病学、内分泌学专家以及初级保健提供者。会议内容参考了一项全国性NASH需求评估调查的结果。与会者回顾并讨论了已发表的关于NAFLD患者(包括NASH患者)的全球负担、筛查、风险分层、诊断和管理的文献。与会者确定了有前景的临床实践方法,并为初级保健提供者和相关专家制定了一项全面、统一的策略,涵盖了NAFLD/NASH护理的各个方面。他们还确定了临床研究的特定高产目标,并呼吁对NAFLD和NASH采取统一的国际公共卫生应对措施。