Eskridge Wayne, Cryer Donna R, Schattenberg Jörn M, Gastaldelli Amalia, Malhi Harmeet, Allen Alina M, Noureddin Mazen, Sanyal Arun J
Fatty Liver Foundation, Boise, ID 83706, USA.
Global Liver Institute, Washington, DC 20016, USA.
J Clin Med. 2023 Sep 26;12(19):6216. doi: 10.3390/jcm12196216.
Diagnosing and managing metabolic dysfunction-associated steatotic liver disease (MASLD) remains a major challenge in primary care due to lack of agreement on diagnostic tools, difficulty in identifying symptoms and determining their cause, absence of approved pharmacological treatments, and limited awareness of the disease. However, prompt diagnosis and management are critical to preventing MASLD from progressing to more severe forms of liver disease. This highlights the need to raise awareness and improve understanding of MASLD among both patients and physicians. The patient perspective is invaluable to advancing our knowledge of this disease and how to manage it, as their perspectives have led to the growing recognition that patients experience subtle symptoms and that patient-reported outcomes should be incorporated into drug development. This review and expert opinion examine MASLD and metabolic dysfunction-associated steatohepatitis from the patient and physician perspective from pre-diagnosis to diagnosis and early care, through to progression to advanced liver damage. Specifically, the paper dives into the issues patients and physicians experience, and, in turn, what is required to improve diagnosis and management, including tips and tools to empower patients and physicians dealing with MASLD.
由于在诊断工具上缺乏共识、难以识别症状并确定其病因、缺乏获批的药物治疗方法以及对该疾病的认知有限,诊断和管理代谢功能障碍相关脂肪性肝病(MASLD)仍然是初级医疗保健中的一项重大挑战。然而,及时诊断和管理对于防止MASLD进展为更严重的肝病形式至关重要。这凸显了提高患者和医生对MASLD的认识并增进理解的必要性。患者的观点对于推进我们对这种疾病及其管理方式的了解非常宝贵,因为他们的观点促使人们越来越认识到患者会经历细微症状,并且患者报告的结果应纳入药物研发中。本综述和专家意见从患者和医生的角度审视了MASLD和代谢功能障碍相关脂肪性肝炎,涵盖从预诊断到诊断和早期护理,直至进展为晚期肝损伤的全过程。具体而言,本文深入探讨了患者和医生所面临的问题,以及反过来改善诊断和管理所需的条件,包括帮助患者和医生应对MASLD的技巧和工具。