Scheen A J, Luyckx F H, Esser N, Lamproye A, Delwaide J, Paquot N
Service de Diabétologie, Nutrition et Maladies métaboliques, CHU Liège, Belgique.
Service de Chimie clinique, CHU Liège, Belgique.
Rev Med Liege. 2022 May;77(5-6):316-322.
Diseases related to fatty liver, independently of alcohol consumption («non-alcoholic fatty liver disease» or NAFLD), are increasing because of the epidemics of obesity and type 2 diabetes. These disorders reflect a continuum that comprises isolated steatosis, steatohepatitis (NASH) and fibrosis, with, at the end, an increased risk of cirrhosis and hepatocarcinoma. It has been recently proposed to replace the term NAFLD by MAFLD, i.e. «Metabolic (dysfunction) Associated Fatty Liver Disease», which better reflects the pathogenesis of the disease. Inflammation plays a crucial role in the aggravation of the disorder and profoundly influences the prognostic evolution. This article illustrates the natural history of this underestimated metabolic disorder, recall the diagnostic criteria used in clinical practice, emphasizes the deleterious role of inflammation and discusses some therapeutic perspectives.
与脂肪肝相关的疾病，与酒精摄入无关（“非酒精性脂肪性肝病”或NAFLD），由于肥胖和2型糖尿病的流行而日益增多。这些病症反映了一个连续过程，包括单纯性脂肪变性、脂肪性肝炎（NASH）和纤维化，最终肝硬化和肝癌的风险增加。最近有人提议用MAFLD取代NAFLD这个术语，即“代谢（功能障碍）相关脂肪性肝病”，它能更好地反映该疾病的发病机制。炎症在疾病的加重过程中起关键作用，并深刻影响预后演变。本文阐述了这种被低估的代谢紊乱的自然史，回顾了临床实践中使用的诊断标准，强调了炎症的有害作用，并讨论了一些治疗前景。
