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国际多学科共识声明:MAFLD 和 CVD 风险。

An international multidisciplinary consensus statement on MAFLD and the risk of CVD.

机构信息

Department of Cardiovascular Medicine, The Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism, University of Verona, Verona, Italy.

出版信息

Hepatol Int. 2023 Aug;17(4):773-791. doi: 10.1007/s12072-023-10543-8. Epub 2023 May 19.

Abstract

BACKGROUND

Fatty liver disease in the absence of excessive alcohol consumption is an increasingly common condition with a global prevalence of ~ 25-30% and is also associated with cardiovascular disease (CVD). Since systemic metabolic dysfunction underlies its pathogenesis, the term metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed for this condition. MAFLD is closely intertwined with obesity, type 2 diabetes mellitus and atherogenic dyslipidemia, which are established cardiovascular risk factors. Unlike CVD, which has received attention in the literature on fatty liver disease, the CVD risk associated with MAFLD is often underestimated, especially among Cardiologists.

METHODS AND RESULTS

A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management.

CONCULSIONS

The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research.

摘要

背景

非过量饮酒导致的脂肪肝疾病是一种日益普遍的病症,全球患病率约为 25-30%,并且与心血管疾病 (CVD) 相关。由于其发病机制与全身性代谢功能障碍有关,因此提出了代谢(功能)相关脂肪性肝病 (MAFLD) 这一术语来描述这种疾病。MAFLD 与肥胖、2 型糖尿病和动脉粥样硬化性血脂异常密切相关,而这些疾病都是已确立的心血管危险因素。与在脂肪肝疾病文献中受到关注的 CVD 不同,MAFLD 相关的 CVD 风险往往被低估,尤其是在心脏病专家中。

方法和结果

一个由来自六大洲(亚洲、欧洲、北美、南美、非洲和大洋洲)的 52 名国际专家组成的多学科小组,包括肝病专家、内分泌专家、糖尿病专家、心脏病专家和家庭医生,参与了一项正式的德尔菲调查,并就 MAFLD 与 CVD 风险之间的关联达成了共识声明。声明涵盖了 CVD 风险的各个方面,从流行病学到机制、筛查和管理。

结论

专家组确定了 MAFLD 与 CVD 风险之间的重要临床关联,这有助于提高对 MAFLD 不良代谢和心血管结局的认识。最后,专家组还提出了未来研究的潜在领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95c7/10198034/f0165d4487d6/12072_2023_10543_Fig1_HTML.jpg

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