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通过结构化生活方式改变干预措施管理非酒精性脂肪性肝病

Managing Nonalcoholic Fatty Liver Disease Through Structured Lifestyle Modification Interventions.

作者信息

Thomas Andrew, Thomas Annie

机构信息

Internal Medicine, Southern Illinois Healthcare, Carbondale, IL, USA (AT).

Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA (AT).

出版信息

Am J Lifestyle Med. 2025 May 26:15598276251346717. doi: 10.1177/15598276251346717.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a significant global health burden. It comprises a broad pathological spectrum ranging from simple liver steatosis to steatohepatitis with variable degrees of fibrosis, and liver failure. Patients with NAFLD have an increased risk of liver-related and overall mortality. While the trials to assess the efficacy of the medications are ongoing, lifestyle modification is the first line of therapy recommended. The primary aim of this review paper is to synthesize literature related to current evidence-based lifestyle interventions for preventing and managing NAFLD. The review and synthesis of the literature reveal that personalized nutritional, exercise, and behavior change interventions are effective in managing NAFLD. Evidence suggests that there are several gaps in managing NAFLD. The gaps discussed in this paper include a lack of awareness of the disease, ineffective patient-provider communication, shortage of specialists, under-recognition of the disease, and liver health disparities. This paper highlights the evidence-based opportunities to overcome those gaps, such as utilizing comprehensive models of care, clinical care pathways, and clinical practice guidelines. Primary care physicians and endocrinologists, who are the first point of contact must utilize these opportunities for diagnosing and managing patients with NAFLD.

摘要

非酒精性脂肪性肝病(NAFLD)是一项重大的全球健康负担。它包括从单纯性肝脂肪变性到伴有不同程度纤维化和肝衰竭的脂肪性肝炎的广泛病理谱。NAFLD患者发生肝脏相关死亡和全因死亡的风险增加。虽然评估药物疗效的试验正在进行中,但生活方式改变是推荐的一线治疗方法。这篇综述论文的主要目的是综合与当前基于证据的预防和管理NAFLD的生活方式干预措施相关的文献。对文献的综述和综合表明,个性化的营养、运动和行为改变干预措施对管理NAFLD有效。有证据表明,在NAFLD的管理方面存在一些差距。本文讨论的差距包括对该疾病缺乏认识、医患沟通无效、专科医生短缺、对该疾病认识不足以及肝脏健康差异。本文强调了基于证据的克服这些差距的机会,例如利用综合护理模式、临床护理路径和临床实践指南。作为首要接触点的初级保健医生和内分泌学家必须利用这些机会来诊断和管理NAFLD患者。

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