Nonalcoholic Fatty Liver Disease: A Review of the Spectrum of Disease, Diagnosis, and Therapy

被引:93
|
作者
Kopec, Krzysztof Lukasz [1 ]
Burns, David [1 ]
机构
[1] Lahey Clin Fdn, Burlington, MA 01805 USA
关键词
fatty liver; liver cirrhosis; non-alcoholic fatty liver disease; obesity; SERUM ALANINE AMINOTRANSFERASE; PLACEBO-CONTROLLED TRIAL; VITAMIN-E TREATMENT; INSULIN-RESISTANCE; HEPATIC STEATOSIS; URSODEOXYCHOLIC ACID; BARIATRIC SURGERY; RISK-FACTORS; HEPATOCELLULAR-CARCINOMA; TRIGLYCERIDE SYNTHESIS;
D O I
10.1177/0884533611419668
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Worldwide, there is an epidemic of obesity and overweight, with two-thirds of Americans affected. A strong association exists between excessive body weight and nonalcoholic fatty liver disease (NAFLD), the most common etiology of abnormal liver function tests. Nonalcoholic fatty liver disease is a spectrum of liver disease, from a "bland" fatty infiltration to chronic hepatitis (nonalcoholic steatohepatitis or NASH), that can result in cirrhosis and organ failure. With the increasing prevalence of obesity in the world, the proportion of people affected by NAFLD is only expected to be parallel. Although primarily noted in obese individuals, NAFLD has also been associated with a number of surgical procedures, metabolic conditions, and medications. NASH is commonly underdiagnosed as most affected patients are symptom free, and routine screening is not performed. Noninvasive diagnostic testing is not sensitive in diagnosis or staging the severity of disease. Fatty infiltration and oxidative injury to the hepatocytes are believed to be the major factors behind the progression of disease from simple fatty infiltration of the liver to chronic hepatitis. Understanding the inflammatory pathways involved in NASH is a subject of extensive research. Currently, few proven treatment options exist, and controlled weight reduction is the only safe modality recommended for treatment of NASH. (Nutr Clin Pract. 2011; 26: 565-576)
引用
收藏
页码:565 / 576
页数:12
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