Department of Internal Medicine, Bethlehem Health Center, Stolberg 52222, Germany.
Department of Internal Medicine II, University Hospital Würzburg, Würzburg 97080, Germany.
World J Gastroenterol. 2021 Sep 21;27(35):5803-5821. doi: 10.3748/wjg.v27.i35.5803.
Nonalcoholic fatty liver disease (NAFLD) is becoming a frequent liver disease, especially in patients with metabolic syndrome and especially in Western countries. Complications of NAFLD comprise progressive fibrosis, cirrhosis and hepatocellular carcinoma. NAFLD also represents an independent risk factor for cardiovascular disease, extrahepatic neoplasia and other organ damage, such as renal insufficiency. Given the epidemiological importance of the disease, new developments in specific treatment of the disease and the wide availability of noninvasive techniques in estimating steatosis and fibrosis, NAFLD should be subject to screening programs, at least in countries with a high prevalence of the disease. The review discusses prerequisites for screening, cost-effectiveness, current guideline recommendations, suitability of techniques for screening and propositions for the following questions: Who should be screened? Who should perform screening? How should screening be performed? It is time for a screening program in patients at risk for NAFLD.
非酒精性脂肪性肝病（NAFLD）正成为一种常见的肝脏疾病，尤其是在代谢综合征患者中，尤其是在西方国家。NAFLD 的并发症包括进行性纤维化、肝硬化和肝细胞癌。NAFLD 也是心血管疾病、肝外肿瘤和其他器官损伤（如肾功能不全）的独立危险因素。鉴于该疾病的流行病学重要性、疾病特异性治疗的新进展以及非侵入性技术在评估脂肪变性和纤维化方面的广泛可用性，NAFLD 应进行筛查，至少在该疾病高发的国家应该进行筛查。本文综述讨论了筛查的前提条件、成本效益、当前指南建议、筛查技术的适用性以及以下问题的建议：谁应该进行筛查？谁来进行筛查？应该如何进行筛查？现在是为有患 NAFLD 风险的患者制定筛查计划的时候了。
