Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Lancet Gastroenterol Hepatol. 2024 Oct;9(10):944-956. doi: 10.1016/S2468-1253(24)00193-6.
The natural history of metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease (NAFLD), is complex and long. A minority of patients develop inflammation and risk progressive fibrosis that can result in cirrhosis. Progression to cirrhosis occurs in 3-5% of patients and often takes more than 20 years. This narrative review presents an update on the natural history of MASLD, discussing studies and risk estimates for progression to severe outcomes, such as decompensated cirrhosis or hepatocellular carcinoma. We highlight the dynamic progression of liver damage, how to identify patients whose disease progresses over time, and how risk factors might be mitigated to reduce the risk for disease progression.
代谢功能障碍相关脂肪性肝病（MASLD）的自然史，以前称为非酒精性脂肪性肝病（NAFLD），是复杂且漫长的。少数患者会出现炎症，并面临进行性纤维化的风险，从而导致肝硬化。进展为肝硬化的患者占 3-5%，通常需要 20 年以上的时间。本综述介绍了 MASLD 的自然史更新，讨论了进展为严重结局（如失代偿性肝硬化或肝细胞癌）的研究和风险估计。我们强调了肝损伤的动态进展，如何识别随着时间推移疾病进展的患者，以及如何减轻风险因素以降低疾病进展的风险。
