Duseja Ajay, Singh S P, De Arka, Madan Kaushal, Rao Padaki Nagaraja, Shukla Akash, Choudhuri Gourdas, Saigal Sanjiv, Arora Anil, Anand Anil C, Das Ashim, Kumar Ashish, Eapen Chundamannil E, Devadas Krishnadas, Shenoy Kotacherry T, Panigrahi Manas, Wadhawan Manav, Rathi Manish, Kumar Manoj, Choudhary Narendra S, Saraf Neeraj, Nath Preetam, Kar Sanjib, Alam Seema, Shah Samir, Nijhawan Sandeep, Acharya Subrat K, Aggarwal Vinayak, Saraswat Vivek A, Chawla Yogesh K
Departmentof Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Gastroenterology, SCB Medical College, Cuttack, India.
J Clin Exp Hepatol. 2023 Mar-Apr;13(2):273-302. doi: 10.1016/j.jceh.2022.11.014. Epub 2022 Dec 7.
Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease globally and in India. The already high burden of NAFLD in India is expected to further increase in the future in parallel with the ongoing epidemics of obesity and type 2 diabetes mellitus. Given the high prevalence of NAFLD in the community, it is crucial to identify those at risk of progressive liver disease to streamline referral and guide proper management. Existing guidelines on NAFLD by various international societies fail to capture the entire landscape of NAFLD in India and are often difficult to incorporate in clinical practice due to fundamental differences in sociocultural aspects and health infrastructure available in India. A lot of progress has been made in the field of NAFLD in the 7 years since the initial position paper by the Indian National Association for the Study of Liver on NAFLD in 2015. Further, the ongoing debate on the nomenclature of NAFLD is creating undue confusion among clinical practitioners. The ensuing comprehensive review provides consensus-based, guidance statements on the nomenclature, diagnosis, and treatment of NAFLD that are practically implementable in the Indian setting.
非酒精性脂肪性肝病(NAFLD)是全球和印度慢性肝病的主要病因。鉴于印度NAFLD的负担本就很高,预计随着肥胖症和2型糖尿病的持续流行,未来这一负担还会进一步加重。鉴于社区中NAFLD的高患病率,识别那些有进展性肝病风险的人对于简化转诊流程和指导正确管理至关重要。各个国际协会现有的NAFLD指南未能涵盖印度NAFLD的全貌,而且由于印度社会文化方面和现有卫生基础设施存在根本差异,这些指南往往难以应用于临床实践。自2015年印度肝脏研究全国协会发表关于NAFLD的初始立场文件以来的7年里,NAFLD领域已经取得了很大进展。此外,目前关于NAFLD命名法的争论在临床医生中造成了不必要的混乱。随后的这份全面综述提供了基于共识的关于NAFLD命名法、诊断和治疗的指导声明,这些声明在印度的环境中切实可行。