Sakaguchi Masaji, Kubota Naoto
Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University.
No Shinkei Geka. 2024 Nov;52(6):1179-1186. doi: 10.11477/mf.1436205034.
Obesity, metabolic syndrome, and fatty liver disease, particularly nonalcoholic fatty liver disease(NAFLD), are significant health issues in current society. These conditions are linked to lifestyle changes such as overeating and lack of exercise, and their prevalence is increasing. Obesity is defined using body mass index(BMI), with a BMI of 25 kg/m or higher considered obese in Japan due to the higher health risks in this population. Obesity significantly increases the risk of diabetes, hypertension, dyslipidemia, cardiovascular disease, and cancer. Metabolic syndrome involves visceral fat accumulation along with high blood glucose levels, dyslipidemia, and hypertension. NAFLD, which is related to metabolic abnormalities such as obesity and diabetes, can progress to non-alcoholic steatohepatitis(NASH), cirrhosis, and liver cancer. Recent concepts, such as metabolic dysfunction-associated fatty liver disease and metabolic dysfunction-associated steatotic liver disease, provide new diagnostic criteria that better identify high-risk patients. The effective management of these diseases involves lifestyle changes and targeted medical treatments. Ongoing research and new diagnostic criteria are expected to improve prevention, diagnosis, and treatment and enhance patient outcomes and quality of life.
肥胖、代谢综合征和脂肪性肝病，尤其是非酒精性脂肪性肝病（NAFLD），是当今社会重要的健康问题。这些病症与暴饮暴食和缺乏运动等生活方式的改变有关，且其患病率正在上升。肥胖是根据体重指数（BMI）来定义的，在日本，由于该人群健康风险较高，BMI达到25千克/平方米或更高被视为肥胖。肥胖会显著增加患糖尿病、高血压、血脂异常、心血管疾病和癌症的风险。代谢综合征包括内脏脂肪堆积以及高血糖水平、血脂异常和高血压。与肥胖和糖尿病等代谢异常相关的NAFLD可进展为非酒精性脂肪性肝炎（NASH）、肝硬化和肝癌。诸如代谢功能障碍相关脂肪性肝病和代谢功能障碍相关脂肪性肝病等最新概念提供了能更好识别高危患者的新诊断标准。对这些疾病的有效管理包括生活方式的改变和针对性的药物治疗。正在进行的研究和新的诊断标准有望改善预防、诊断和治疗，并提高患者的治疗效果和生活质量。
