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解读非酒精性脂肪性肝病临床实践指南:临床医生需要了解的内容

Making Sense of the Nonalcoholic Fatty Liver Disease Clinical Practice Guidelines: What Clinicians Need to Know.

作者信息

Cusi Kenneth, Budd Jeff, Johnson Eric, Shubrook Jay

机构信息

Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL.

Division of General Internal Medicine, University of Florida, Gainesville, FL.

出版信息

Diabetes Spectr. 2024 Winter;37(1):29-38. doi: 10.2337/dsi23-0014. Epub 2024 Feb 15.

DOI:10.2337/dsi23-0014
PMID:38385100
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10877212/
Abstract

Standards of care summarized in clinical practice guidelines for nonalcoholic fatty liver disease (NAFLD) offer clinicians a streamlined diagnostic and management approach based on the best available evidence. These recommendations have changed a great deal in recent years; today, there is a clear focus on screening for the early identification and risk stratification of patients at high risk of steatohepatitis and clinically significant fibrosis to promote timely referrals to specialty care when needed. This article reviews and provides the rationale for current guidelines for NAFLD screening, diagnosis, treatment, and monitoring and addresses barriers to providing evidence-based NAFLD care and how to overcome them. The current paradigm of care calls for primary care clinicians and specialists to work together, within a multidisciplinary care team familiar with obesity and diabetes care, to provide comprehensive management of these complex patients.

摘要

非酒精性脂肪性肝病(NAFLD)临床实践指南中总结的护理标准为临床医生提供了一种基于现有最佳证据的简化诊断和管理方法。近年来,这些建议发生了很大变化;如今,明确重点在于筛查,以早期识别非酒精性脂肪性肝炎和具有临床意义的肝纤维化高危患者并进行风险分层,以便在需要时及时转诊至专科护理。本文回顾并阐述了当前NAFLD筛查、诊断、治疗和监测指南的基本原理,并探讨了提供循证NAFLD护理的障碍以及如何克服这些障碍。当前的护理模式要求初级保健临床医生和专科医生在熟悉肥胖症和糖尿病护理的多学科护理团队中共同合作,为这些复杂患者提供全面管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cd6/10877212/483b58862908/diaspectdsi230014f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cd6/10877212/62b9f39e9c15/diaspectdsi230014f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cd6/10877212/483b58862908/diaspectdsi230014f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cd6/10877212/62b9f39e9c15/diaspectdsi230014f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cd6/10877212/483b58862908/diaspectdsi230014f2.jpg

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本文引用的文献

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Understanding the Burden of Nonalcoholic Fatty Liver Disease: Time for Action.认识非酒精性脂肪性肝病的负担:行动时刻到了。
Diabetes Spectr. 2024 Winter;37(1):9-19. doi: 10.2337/dsi23-0010. Epub 2024 Feb 15.
3
Pharmacological Approaches to Nonalcoholic Fatty Liver Disease: Current and Future Therapies.非酒精性脂肪性肝病的药理学治疗方法:当前与未来的疗法
胰岛素抵抗在2型糖尿病患者非酒精性脂肪性肝病发生发展中的作用:从实验室到患者护理
Diabetes Spectr. 2024 Winter;37(1):20-28. doi: 10.2337/dsi23-0013. Epub 2024 Feb 15.
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Nonalcoholic Fatty Liver Disease in Diabetes: A Call to Action.糖尿病中的非酒精性脂肪性肝病:行动呼吁
Diabetes Spectr. 2024 Winter;37(1):5-7. doi: 10.2337/dsi23-0015. Epub 2024 Feb 15.
Diabetes Spectr. 2024 Winter;37(1):48-58. doi: 10.2337/dsi23-0012. Epub 2024 Feb 15.
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A survey on the awareness, current management, and barriers for non-alcoholic fatty liver disease among the general Korean population.一项针对韩国普通人群对非酒精性脂肪性肝病的认知、当前管理和障碍的调查。
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