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代谢性疾病与肝脏:综述

Metabolic disease and the liver: A review.

作者信息

Vargas Márcia, Cardoso Toniasso Sheila de Castro, Riedel Patricia G, Baldin Camila Pereira, Dos Reis Francielle Lopes, Pereira Robson Martins, Brum Maria Carlota Borba, Joveleviths Dvora, Alvares-da-Silva Mario Reis

机构信息

Program of Graduate Science in Gastroenterology and Hepatology, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, Rio Grande do Sul, Brazil.

School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, Brazil.

出版信息

World J Hepatol. 2024 Jan 27;16(1):33-40. doi: 10.4254/wjh.v16.i1.33.

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease worldwide, with an estimated prevalence of 31% in Latin America. The presence of metabolic comorbidities coexisting with liver disease varies substantially among populations. It is acknowledged that obesity is boosting the type 2 diabetes mellitus "epidemic," and both conditions are significant contributors to the increasing number of patients with MASLD. Non-alcoholic steatohepatitis represents a condition of chronic liver inflammation and is considered the most severe form of MASLD. MASLD diagnosis is based on the presence of steatosis, noninvasive scores and altered liver tests. Noninvasive scores of liver fibrosis, such as serum biomarkers, which should be used in primary care to rule out advanced fibrosis, are simple, inexpensive, and widely available. Currently, guidelines from international hepatology societies recommend using noninvasive strategies to simplify case finding and management of high-risk patients with MASLD in clinical practice. Unfortunately, there is no definite pharmacological treatment for the condition. Creating public health policies to treat patients with risk factors for MASLD prevention is essential.

摘要

代谢功能障碍相关脂肪性肝病(MASLD)是全球最常见的肝脏疾病,在拉丁美洲估计患病率为31%。与肝脏疾病并存的代谢合并症在不同人群中差异很大。人们认识到肥胖正在推动2型糖尿病的“流行”,这两种情况都是导致MASLD患者数量增加的重要因素。非酒精性脂肪性肝炎代表一种慢性肝脏炎症状态,被认为是MASLD最严重的形式。MASLD的诊断基于脂肪变性的存在、非侵入性评分和肝功能检查异常。肝脏纤维化的非侵入性评分,如血清生物标志物,在初级保健中用于排除晚期纤维化,简单、廉价且广泛可用。目前,国际肝病学会的指南建议在临床实践中使用非侵入性策略来简化MASLD高危患者的病例发现和管理。不幸的是,目前尚无针对该疾病的确切药物治疗方法。制定公共卫生政策以治疗有MASLD预防风险因素的患者至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cde6/10835488/423a7820bf50/WJH-16-33-g001.jpg

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