Hosseeini Sayed Mohammad, Jafari Mohammad, Tahmasebi Marzieh, Adibi Payman
Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Clinical Informationist Research Group, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2024 Aug 5;15:27. doi: 10.4103/ijpvm.ijpvm_284_22. eCollection 2024.
Non-alcoholic fatty liver disease (NAFLD) refers to the presence of hepatic steatosis (accumulation of fat in the liver to over 5% of its weight) in the absence of secondary causes of fat accumulation in the liver such as excessive alcohol use. NAFLD is divided into two types: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Therefore, in this clinical guideline, we sought to determine general and important policies for this disease and modify its managment approaches. We adapted this guideline for the management of NAFLD in Isfahan Province. This guideline was developed by clinical appraisal and review of the evidence, available clinical guidelines, and in consultation with members of the Isfahan Chamber of the Iranian Association of Gastroenterology and Hepatology. Biopsy is recommended as the most reliable method (gold standard) to diagnose steatohepatitis and fibrosis in patients with NAFLD. NAFLD fibrosis score (NFS) and fibrosis-4 (FIB-4) are recommended as the test with the highest predictive value for advanced fibrosis in patients with NAFLD compared to other serologic tests. Among the noninvasive methods used to assess liver fibrosis, transient elastography (TE) is preferable to other methods.
非酒精性脂肪性肝病（NAFLD）是指在没有肝脏脂肪堆积的继发原因（如过量饮酒）的情况下，肝脏出现脂肪变性（肝脏中脂肪堆积超过其重量的5%）。NAFLD分为两种类型：非酒精性脂肪肝（NAFL）和非酒精性脂肪性肝炎（NASH）。因此，在本临床指南中，我们试图确定针对该疾病的一般和重要政策，并修改其管理方法。我们对伊斯法罕省NAFLD的管理采用了本指南。本指南是通过对证据、现有临床指南进行临床评估和审查，并与伊朗胃肠病学和肝病学协会伊斯法罕分会的成员协商制定的。活检被推荐为诊断NAFLD患者脂肪性肝炎和纤维化的最可靠方法（金标准）。与其他血清学检测相比，NAFLD纤维化评分（NFS）和纤维化-4（FIB-4）被推荐为对NAFLD患者晚期纤维化预测价值最高的检测。在用于评估肝纤维化的非侵入性方法中，瞬时弹性成像（TE）比其他方法更可取。
