Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.
Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
Clin Mol Hepatol. 2023 Feb;29(Suppl):s86-s102. doi: 10.3350/cmh.2022.0442. Epub 2023 Jan 5.
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease characterized by excess fat accumulation in the liver. It is closely associated with metabolic syndrome, and patients with NAFLD often have comorbidities such as obesity, type 2 diabetes mellitus, and dyslipidemia. In addition to liver-related complications, NAFLD has been associated with a range of non-liver comorbidities, including cardiovascular disease, chronic kidney disease, and sleep apnea. Cardiovascular disease is the most common cause of mortality in patients with NAFLD, and patients with NAFLD have a higher risk of developing cardiovascular disease than the general population. Chronic kidney disease is also more common in patients with NAFLD, and the severity of NAFLD is associated with a higher risk of developing chronic kidney disease. Sleep apnea, a disorder characterized by breathing interruptions during sleep, is also more common in patients with NAFLD and is associated with the severity of NAFLD. The presence of non-liver comorbidities in patients with NAFLD has important implications for the management of this disease. Treatment of comorbidities such as obesity, type 2 diabetes mellitus, and dyslipidemia may improve liver-related outcomes in patients with NAFLD. Moreover, treatment of non-liver comorbidities may also improve overall health outcomes in patients with NAFLD. Therefore, clinicians should be aware of the potential for non-liver comorbidities in patients with NAFLD and should consider the management of these comorbidities as part of the overall management of this disease.
非酒精性脂肪性肝病（NAFLD）是一种以肝脏脂肪堆积为特征的慢性肝病。它与代谢综合征密切相关，NAFLD 患者常伴有肥胖、2 型糖尿病和血脂异常等合并症。除了与肝脏相关的并发症外，NAFLD 还与一系列非肝脏合并症相关，包括心血管疾病、慢性肾脏病和睡眠呼吸暂停。心血管疾病是 NAFLD 患者最常见的死亡原因，NAFLD 患者发生心血管疾病的风险高于普通人群。慢性肾脏病在 NAFLD 患者中也更为常见，且 NAFLD 的严重程度与发生慢性肾脏病的风险增加相关。睡眠呼吸暂停是一种以睡眠期间呼吸中断为特征的疾病，在 NAFLD 患者中也更为常见，且与 NAFLD 的严重程度相关。NAFLD 患者存在非肝脏合并症对该疾病的管理具有重要意义。治疗肥胖、2 型糖尿病和血脂异常等合并症可能改善 NAFLD 患者的肝脏相关结局。此外，治疗非肝脏合并症也可能改善 NAFLD 患者的整体健康结局。因此，临床医生应意识到 NAFLD 患者存在非肝脏合并症的可能性，并应考虑将这些合并症的管理作为该疾病整体管理的一部分。
