School of Medicine, University of Zagreb, Zagreb, Croatia.
Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Acta Clin Croat. 2021 Dec;60(Suppl 2):36-52. doi: 10.20471/acc.2021.60.s1.03.
Nonalcoholic fatty liver disease (NAFLD) is a term describing excessive accumulation of fat in hepatocytes, and is associated with metabolic syndrome and insulin resistance. NAFLD prevalence is on increase and goes in parallel with the increasing prevalence of metabolic syndrome and its components. That is why Croatian guidelines have been developed, which cover the screening protocol for patients with NAFLD risk factors, and the recommended diagnostic work-up and treatment of NAFLD patients. NAFLD screening should be done in patients with type 2 diabetes mellitus, or persons with two or more risk factors as part of metabolic screening, and is carried out by noninvasive laboratory and imaging methods used to detect fibrosis. Patient work-up should exclude the existence of other causes of liver injury and determine the stage of fibrosis as the most important factor in disease prognosis. Patients with initial stages of fibrosis continue to be monitored at the primary healthcare level with the management of metabolic risk factors, dietary measures, and increased physical activity. Patients with advanced fibrosis should be referred to a gastroenterologist/hepatologist for further treatment, monitoring, and detection and management of complications.
非酒精性脂肪性肝病（NAFLD）是指肝细胞内脂肪过度堆积的一种病症，与代谢综合征和胰岛素抵抗有关。NAFLD 的患病率正在上升，与代谢综合征及其组成部分的患病率上升呈平行关系。正因为如此，克罗地亚制定了相关指南，涵盖了具有 NAFLD 危险因素患者的筛查方案，以及 NAFLD 患者的推荐诊断方法和治疗方案。NAFLD 的筛查应在 2 型糖尿病患者或具有代谢综合征筛查中两种或更多种危险因素的人群中进行，通过非侵入性的实验室和影像学方法来检测纤维化。患者的检查应排除其他肝脏损伤的原因，并确定纤维化分期作为疾病预后的最重要因素。处于纤维化早期的患者应继续在初级保健水平上进行监测，管理代谢危险因素、饮食措施和增加身体活动。患有晚期纤维化的患者应转介给胃肠病学家/肝病学家进行进一步治疗、监测以及并发症的检测和管理。
