Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria.
National Institute for Health and Care Research, Southampton Biomedical Research Centre, University Hospital Southampton and University of Southampton, Southampton, UK.
Lancet Gastroenterol Hepatol. 2023 Oct;8(10):943-954. doi: 10.1016/S2468-1253(23)00159-0. Epub 2023 Aug 16.
Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. Although NAFLD is tightly linked to obesity and type 2 diabetes, this liver disease also affects individuals who do not have obesity. NAFLD increases the risk of developing cardiovascular disease, chronic kidney disease, and certain extrahepatic cancers. There is currently no licensed pharmacotherapy for NAFLD, despite numerous clinical trials in the past two decades. Currently, the reason so few drugs have been successful in the treatment of NAFLD in a trial setting is not fully understood. As cardiovascular disease is the predominant cause of mortality in people with NAFLD, future pharmacotherapies for NAFLD must consider associated cardiometabolic risk factors. The successful use of glucose-lowering drugs in the treatment of type 2 diabetes in patients with NAFLD indicates that this strategy is important, and worth developing further. Greater public awareness of NAFLD is needed because collaboration between all stakeholders is vital to enable a holistic approach to successful treatment.
非酒精性脂肪性肝病（NAFLD）已成为全球最常见的慢性肝病。尽管 NAFLD 与肥胖和 2 型糖尿病密切相关，但这种肝病也会影响没有肥胖的个体。NAFLD 会增加患心血管疾病、慢性肾脏病和某些肝外癌症的风险。尽管过去二十年进行了许多临床试验，但目前仍没有针对 NAFLD 的许可药物治疗方法。目前，在临床试验中，很少有药物能成功治疗 NAFLD 的原因尚不完全清楚。由于心血管疾病是 NAFLD 患者死亡的主要原因，因此未来治疗 NAFLD 的药物必须考虑相关的心血管代谢危险因素。在患有 NAFLD 的 2 型糖尿病患者中成功使用降糖药物表明，这种策略很重要，值得进一步发展。需要提高公众对 NAFLD 的认识，因为所有利益相关者之间的合作对于实现成功治疗的整体方法至关重要。
