代谢相关脂肪性肝病的危害和饮食治疗对策

摘要/Abstract

摘要： 代谢相关脂肪性肝病(MAFLD)影响全球25%的成人,可与其他慢性肝病合并存在。MAFLD不但与慢性肝炎、肝硬化、肝细胞癌密切相关,还与代谢综合征和2型糖尿病互为因果共同促进动脉硬化性心脑血管疾病、慢性肾病和肝外恶性肿瘤的发病。至今无治疗MAFLD的特效药物,改变生活方式是兼顾防治代谢心血管疾病和肝脏炎症损伤的一线治疗措施,饮食处方减肥是MAFLD及其合并症防治的基石。

关键词: 代谢相关脂肪性肝病, 流行病学, 预后, 饮食治疗

陈镜宇, 范建高. 代谢相关脂肪性肝病的危害和饮食治疗对策[J]. 肝脏, 2021, 26(11): 1287-1289.

[1] 中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018更新版). 实用肝脏病杂志,2018, 21:177-186.
[2] 范建高,曾静. 非酒精性脂肪性肝病的流行现状与危害.中华消化杂志,2020,40:577-580.
[3] Younossi ZM,Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology, 2016, 64:73-84.
[4] Yki-Järvinen H, Luukkonen PK, Hodson L, et al. Dietary carbohydrates and fats in nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol, 2021, 18:770-786.
[5] European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease.J Hepatol, 2016, 64:1388-1402.
[6] Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 2018, 67:328-357.
[7] Chitturi S, Wong VW, Chan WK, et al. The Asia-Pacific Working Party on Nonalcoholic Fatty Liver Disease Guidelines 2017 Part 2: Management and special groups. J Gastroenterol Hepatol, 2018, 33:86-98.
[8] Eslam M, Sanyal AJ, George J. International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology, 2020, 158:1999-2014.e1.
[9] Eslam M, Newsome PN, Anstee QM, et al. A new definition for metabolic associated fatty liver disease: an international expert consensus statement. J Hepatol, 2020,73:202-209.
[10] Nan Y, An J, Bao J, Chen H, et al. The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease. J Hepatol, 2021, 75:454-461.
[11] Eslam M, Sarin SK, Wong VW, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. Hepatol Int, 2020,14:889-919.
[12] 季蕾,范建高,李锋.男性酒精性和非酒精性脂肪性肝病患者代谢异常的比较. 肝脏,2021,26:60-63.
[13] Ioannou GN. Epidemiology and risk-stratification of NAFLD-associated HCC. J Hepatol, 2021.
[14] Loomba R, Lim JK, Patton H, et al. AGA Clinical Practice Update on Screening and Surveillance for Hepatocellular Carcinoma in Patients With Nonalcoholic Fatty Liver Disease: Expert Review. Gastroenterology. 2020, 158:1822-1830.
[15] Ren TY, Fan JG. What are the clinical settings and outcomes of lean NAFLD? Nat Rev Gastroenterol Hepatol, 2021,18:289-290.
[16] Chang XJ, Shi YW, Wang J, et al. Influence of weight management on the prognosis of steatohepatitis in chronic hepatitis B patients during antiviral treatment. Hepatobiliary Pancreat Dis Int, 2021, 20:416-425.
[17] 中国研究型医院学会肝病专业委员会,中国医师协会脂肪性肝病专家委员会,中华医学会肝病学分会脂肪肝和酒精性肝病学组,等. 脂肪性肝病诊疗规范化的专家建议(2019年修订版). 实用肝脏病杂志, 2019, 22:787-792.
[18] Targher G, Tilg H, Byrne CD. Non-alcoholic fatty liver disease: a multisystem disease requiring a multidisciplinary and holistic approach. Lancet Gastroenterol Hepatol, 2021,6:578-588.
[19] Lazarus JV, Anstee QM, Hagstr?m H, et al. Defining comprehensive models of care for NAFLD. Nat Rev Gastroenterol Hepatol, 2021,18:717-729.
[20] 范建高. 加强非酒精性脂肪性肝病患者生活方式的管理. 中华健康管理杂志, 2020, 14:308-312.
[21] Fan JG, Cao HX. Role of diet and nutritional management in non-alcoholic fatty liver disease. J Gastroenterol Hepatol, 2013, 28 Suppl 4:81-87.
[22] George ES, Forsyth A, Itsiopoulos C, et al. Practical dietary recommendations for the prevention and management of nonalcoholic fatty liver disease in adults. Adv Nutr, 2018,9:30-40.
[23] Vancells Lujan P, Vi? asEsmel E, SacanellaMeseguer E. Overview of non-alcoholic fatty liver disease (NAFLD) and the role of sugary food consumption and other dietary components in its development.Nutrients, 2021,13:1442.

代谢相关脂肪性肝病的危害和饮食治疗对策

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