Alcoholic and non-alcoholic steatohepatitis: Who is affected and what can we do for them?

被引:5
|
作者
Gallego-Duran, Rocio
Ampuero, Javier
Funuyet, Jorge
Romero-Gomez, Manuel [1 ]
机构
[1] Univ Seville, Unidad Med Quirurg Enfermedades Digest, Seville, Spain
来源
GASTROENTEROLOGIA Y HEPATOLOGIA | 2013年 / 36卷 / 09期
关键词
Alcoholic steatohepatitis; Non-alcoholic steatohepatitis; Noninvasive diagnosis; Pathogenic mechanisms of steatohepatitis; Therapeutic management; FATTY LIVER-DISEASE; PLACEBO-CONTROLLED TRIAL; VITAMIN-E; NONINVASIVE ASSESSMENT; INCREASED EXPRESSION; HEPATIC STEATOSIS; NATURAL-HISTORY; DIAGNOSIS; PIOGLITAZONE; METFORMIN;
D O I
10.1016/j.gastrohep.2013.06.005
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The most common causes of steatohepatitis are alcohol intake and metabolic disorders. Several methods based on biochemical determinations (carbohydrate deficient transferrin) and questionnaires (AUDIT, CAGE, MALE) are useful for detecting surreptitious alcohol intake. Although new non-invasive methods are under development, based both on lipidomics (Owl-Liver (R)) and on biochemical determinations and anthropometric parameters (NAFLD Fibrosis score) or imaging methods (DeMILI NASH-MRi (R)), none has been proposed as definitive and the gold standard continues to be liver biopsy. The pathogenesis of alcoholic and non-alcoholic steatohepatitis shares some elements such as insulin resistance, cytochrome CYP2E1-mediated oxidative stress, adiponutrin and its PNPLA3 gene, and the microbiota. The first-line treatment consists of lifestyle changes, including giving up alcohol, diet and exercise. (C) 2013 Elsevier Espana, S.L. and AEEH y AEG. All rights reserved.
引用
收藏
页码:587 / 596
页数:10
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