PDF下载 ( 260 KB)
Consensus for diagnosis and treatment of nonalcoholic fatty liver diseases and metabolic disorders (2nd Edition)
-
摘要:
<正>非酒精性脂肪性肝病（NAFLD）是指除外过量饮酒和其他明确的损肝因素所致的肝细胞内脂肪沉积,包括从单纯的肝脂肪变性（NAFL）到非酒精性脂肪性肝炎（NASH）,以致一部分最终发展为肝硬化,甚至演变为肝细胞癌（HCC）。目前,NAFLD全球及亚洲人群患病率约为25%[1-2]。我国NAFLD患病率也不容乐观,因检测方法不同,中国成人NAFLD患病率
-
Key words:
- non alcoholic fatty liver disease /
- metabolic syndrome X /
- diagnosis /
- therapeutics /
- consensus
-
[1]YOUNOSSI ZM, KOENIG AB, ABDELATIF D, et al.Global epidemiology of nonalcoholic fatty Liver disease-meta-analytic assessment of prevalence, incidence, and outcomes[J].Hepatology, 2016, 64 (1) :73-84. [2]FAN JG, KIM SU, WONG VW.New trends on obesity and NAFLDin Asia[J].J Hepatol, 2017, 67 (4) :862-873. [3]FAN JG.Epidemiology of alcoholic and nonalcoholic fatty liver disease in China[J].J Gastroenterol Hepatol, 2013, 28 (Suppl 1) :11-17. [4]WANG FS, FAN JG, ZHANG Z, et al.The global burden of liver disease:the major impact of China[J].Hepatology, 2014, 60 (6) :2099-2108. [5]FAN JG, ZHU J, LI XJ, et al.Prevalence of and risk factors for fatty liver in a general population of Shanghai, China[J].J Hepatol, 2005, 43 (3) :508-514. [6]ANGULO P.Medical progress-Nonalcoholic fatty liver disease[J].N Engl J Med, 2002, 346 (16) :1221-1231. [7]WILLIAMSON RM, PRICE JF, GLANCY S, et al.Prevalence of and risk factors for hepatic steatosis and nonalcoholic fatty liver disease in people with type 2 diabetes:the edinburgh type 2 diabetes study[J].Diabetes Care, 2011, 34 (5) :1139-1144. [8]TARGHER G, BERTOLINI L, PADOVANI R, et al.Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients[J].Diabetes Care, 2007, 30 (5) :1212-1218. [9]PETIT JM, GUIU B, TERRIAT B, et al.Nonalcoholic fatty liver is not associated with carotid intima-media thickness in type 2 diabetic patients[J].J Clin Endocrinol Metab, 2009, 94 (10) :4103-4106. [10]BRIL F, CUSI K.Nonalcoholic fatty liver disease:The new complication of type 2 diabetes mellitus[J].Endocrinol Metab Clin North Am, 2016, 45 (4) :765-781. [11]LEITE NC, VILLELA-NOGUEIRA CA, PANNAIN VL, et al.Histopathological stages of nonalcoholic fatty liver disease in type 2diabetes:prevalences and correlated factors[J].Liver Int, 2011, 31 (5) :700-706. [12]FRACANZANI AL, VALENTI L, BUGIANESI E, et al.Risk of severe liver disease in nonalcoholic fatty liver disease with normal aminotransferase levels:a role for insulin resistance and diabetes[J].Hepatology, 2008, 48 (3) :792-798. [13]KWOK R, CHOI KC, WONG GL, et al.Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements:a prospective cohort study[J].Gut, 2016, 65 (8) :1359-1368. [14]KOEHLER EM, PLOMPEN EP, SCHOUTEN JN, et al.Presence of diabetes mellitus and steatosis is associated with liver stiffness in a general population:The Rotterdam study[J].Hepatology, 2016, 63 (1) :138-147. [15]LIU M, YAN HM, GAO X, et al.Association of abnormality of liver enzymes and metabolic syndrome in patients with nonalcohoblic fatty liver disease[J].Natl Med J China, 2007, 87 (4) :253-255. (in Chinese) 刘蒙, 颜红梅, 高鑫, 等.非酒精性脂肪肝病患者中肝酶与代谢综合征的关系[J].中华医学杂志, 2007, 87 (4) :253-255. [16]ZHANG LS, BIAN H, YAN HM, et al.The relationship between liver fat content and liver disease outcome in patients with type 2 diabetes[J].Chin J Endocrinol Metab, 2014, 30 (1) :3-7. (in Chinese) 张林杉, 卞华, 颜红梅, 等.2型糖尿病患者肝脏脂肪含量与肝病结局的相关性研究[J].中华内分泌代谢杂志, 2014, 30 (1) :3-7. [17]ARMSTRONG MJ, ADAMS LA, CANBAY A, et al.Extrahepatic complications of nonalcoholic fatty liver disease[J].Hepatology, 2014, 59 (3) :1174-1197. [18]MANTOVANI A, ZAZA G, BYRNE CD, et al.Nonalcoholic fatty liver disease increases risk of incident chronic kidney disease:Asystematic review and meta-analysis[J].Metabolism, 2018, 79:64-76. [19]XIA MF, LIN HD, YAN HM, et al.The association of liver fat content and serum alanine aminotransferase with bone mineral density in middle-aged and elderly Chinese men and postmenopausal women[J].J Transl Med, 2016, 14:11. [20]WANG D, LIN H, XIA M, et al.Vitamin D levels are inversely associated with liver fat content and risk of non-alcoholic fatty liver disease in a Chinese middle-aged and elderly population:The Shanghai Changfeng study[J].PLo S One, 2016, 11 (6) :e0157515. [21]LIN H, LI Q, LIU X, et al.Liver fat content is associated with elevated serum uric acid in the Chinese middle-aged and elderly populations:Shanghai Changfeng study[J].PLo S One, 2015, 10 (10) :e0140379. [22]ADAMS LA, ANSTEE QM, TILG H, et al.Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases[J].Gut, 2017, 66 (6) :1138-1153. [23]ROCHA ALL, FARIA LC, GUIMARAES TCM, et al.Non-alcoholic fatty liver disease in women with polycystic ovary syndrome:systematic review and meta-analysis[J].J Endocrinol Invest, 2017, 40 (12) :1279-1288. [24]LI Y, XU C, YU C, et al.Association of serum uric acid level with non-alcoholic fatty liver disease:a cross-sectional study[J].JHepatol, 2009, 50 (5) :1029-1034. [25]BHALA N, ANGULO P, van der POORTEN D, et al.The natural history of nonalcoholic fatty liver disease with advanced fibrosis or cirrhosis:an international collaborative study[J].Hepatology, 2011, 54 (4) :1208-1216. [26]VOZAROVA B, STEFAN N, LINDSAY RS, et al.High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes[J].Diabetes, 2002, 51 (6) :1889-1895. [27]ADAMS LA, WATERS OR, KNUIMAN MW, et al.NAFLD as a risk factor for the development of diabetes and the metabolic syndrome:an eleven-year follow-up study[J].Am J Gastroenterol, 2009, 104 (4) :861-867. [28]BALLESTRI S, ZONA S, TARGHER G, et al.Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome.Evidence from a systematic review and meta-analysis[J].J Gastroenterol Hepatol, 2016, 31 (5) :936-944. [29] National Workshop on Liver disease and Metabolism, Chinese Society of Endocrinology, Chinese Medical Association.Consensus for diagnosis and treatment of nonalcoholic fatty liver disease and metabolic disorders[J].Chin J Endocrinol Metab, 2010, 26 (7) :531-534. (in Chinese) 中华医学会内分泌学分会肝病与代谢学组 (筹) .中华医学会内分泌学分会“非酒精性脂肪性肝病与相关代谢紊乱诊疗共识”[J].中华内分泌代谢杂志, 2010, 26 (7) :531-534. [30]National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association;Fatty Liver Expert Committee, Chinese Medical Doctor Association.Guidelines of prevention and treatment for nonalcoholic fatty liver disease:a 2018 update[J].J Clin Hepatol, 2018, 34 (5) :947-957. (in Chinese) 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年更新版) [J].临床肝胆病杂志, 2018, 34 (5) :947-957. [31]HABERFELLNER EM, HONSIG T.Nonalcoholic steatohepatitis:a possible side effect of atypical antipsychotics[J].J Clin Psychiatry, 2003, 64 (7) :851. [32]FARRELL GC, CHITTURI S, LAU GK, et al.Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region:executive summary[J].J Gastroenterol Hepatol, 2007, 22 (6) :775-777. [33]ALI R, CUSI K.New diagnostic and treatment approaches in nonalcoholic fatty liver disease (NAFLD) [J].Ann Med, 2009, 41 (4) :265-278. [34]WONG VW, CHAN WK, CHITTURI S, et al.Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines2017-Part 1:Definition, risk factors and assessment[J].J Gastroenterol Hepatol, 2018, 33 (1) :70-85. [35]SZCZEPANIAK LS, NURENBERG P, LEONARD D, et al.Magnetic resonance spectroscopy to measure hepatic triglyceride content:prevalence of hepatic steatosis in the general population[J].Am J Physiol Endocrinol Metab, 2005, 288 (2) :E462-468. [36]XIA MF, YAN HM, HE WY, et al.Standardized ultrasound hepatic/renal ratio and hepatic attenuation rate to quantify liver fat content:an improvement method[J].Obesity (Silver Spring) , 2012, 20 (2) :444-452. [37]ZENG J, SUN WL, CHEN GY, et al.Efficiency of FibroScan and FibroTouch in liver stiffness measurement and fat quantification:a comparative analysis[J].Chin J Hepatol, 2016, 24 (9) :652-658. (in Chinese) 曾静, 孙婉璐, 陈光榆, 等.FibroTouch与FibroScan肝脏硬度和脂肪定量检测效能的比较[J].中华肝脏病杂志, 2016, 24 (9) :652-658. [38]SINGH S, MUIR AJ, DIETERICH DT, et al.American Gastroenterological Association institute technical review on the role of elastography in chronic liver diseases[J].Gastroenterology, 2017, 152 (6) :1544-1577. [39]KLEINER DE, BRUNT EM, van NATTA M, et al.Design and validation of a histological scoring system for nonalcoholic fatty liver disease[J].Hepatology, 2005, 41 (6) :1313-1321. [40]CUSI K.Treatment of patients with type 2 diabetes and non-alcoholic fatty liver disease:current approaches and future directions[J].Diabetologia, 2016, 59 (6) :1112-1120. [41]KLEINER DE, BRUNT EM.Nonalcoholic fatty liver disease:pathologic patterns and biopsy evaluation in clinical research[J].Semin Liver Dis, 2012, 32 (1) :3-13. [42]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].J Hepatol, 2016, 64 (6) :1388-1402. [43]SANYAL AJ, CHALASANI N, KOWDLEY KV, et al.Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis[J].NEngl J Med, 2010, 362 (18) :1675-1685. [44]ANGULO P, HUI JM, MARCHESINI G, et al.The NAFLD fibrosis score:A noninvasive system that identifies liver fibrosis in patients with NAFLD[J].Hepatology, 2007, 45 (4) :846-854. [45]CHALASANI N, YOUNOSSI Z, LAVINE JE, et al.The diagnosis and management of non-alcoholic fatty liver disease:Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association[J].Hepatology, 2012, 142 (7) :1592-1609. [46]MUSSO G, GAMBINO R, CASSADER M, et al.Meta-analysis:natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity[J].Ann Med, 2011, 43 (8) :617-649. [47]ANSTEE QM, TARGHER G, DAY CP.Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis[J].Nat Rev Gastroenterol Hepatol, 2013, 10 (6) :330-344. [48]KOZLITINA J, SMAGRIS E, STENDER S, et al.Exome-wide association study identifies a TM6SF2 variant that confers susceptibility to nonalcoholic fatty liver disease[J].Nat Genet, 2014, 46 (4) :352-356. [49]XIA MF, LING Y, BIAN H, et al.I148M variant of PNPLA3 increases the susceptibility to non-alcoholic fatty liver disease caused by obesity and metabolic disorders[J].Aliment Pharmacol Ther, 2016, 43 (5) :631-642. [50]LI Y, XING C, TIAN Z, et al.Genetic variant I148M in PNPLA3 is associated with the ultrasonography-determined steatosis degree in a Chinese population[J].BMC Med Genet, 2012, 13:113. [51]WANG XL, LIU ZP, WANG K, et al.Additive effects of the risk alleles of PNPLA3 and TM6SF2 on non-alcoholic fatty liver disease (NAFLD) in a Chinese population[J].Front Genet, 2016, 7:140. [52]International Diabetes Federation.Criteria for metabolic syndrom.Cited2004[J].AvailablefromURL:http://www.idf.org/webdata/docs/IDF_metasyndmme-definitions.pdf. [53]VUPPALANCHI R, CHALASANI N.Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis:Selected practical issues in their evaluation and management[J].Hepatology, 2009, 49 (1) :306-317. [54]ONI ET, AGATSTON AS, BLAHA MJ, et al.A systematic review:burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver;should we care?[J].Atherosclerosis, 2013, 230 (2) :258-267. [55]TARGHER G, DAY CP, BONORA E.Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease[J].N Engl JMed, 2010, 363 (14) :1341-1350. [56]SPELIOTES EK, MASSARO JM, HOFFMANN U, et al.Fatty liver is associated with dyslipidemia and dysglycemia independent of visceral fat:the Framingham Heart Study[J].Hepatology, 2010, 51 (6) :1979-1987. [57]RAFIQ N, BAI C, FANG Y, et al.Long-term follow-up of patients with nonalcoholic fatty liver[J].Clin Gastroenterol Hepatol, 2009, 7 (2) :234-238. [58]WILSON PW, D'AGOSTINO RB, LEVY D, et al.Prediction of coronary heart disease using risk factor categories[J].Circulation, 1998, 97 (18) :1837-1847. [59]ZHANG HJ, HE J, PAN LL, et al.Effects of moderate and vigorous exercise on nonalcoholic fatty liver disease:A randomized clinical trial[J].JAMA Intern Med, 2016, 176 (8) :1074-1082. [60]ZHANG HJ, PAN LL, MA ZM, et al.Long-term effect of exercise on improving fatty liver and cardiovascular risk factors in obese adults:A 1-year follow-up study[J].Diabetes Obes Metab, 2017, 19 (2) :284-289. [61]SCHUGAR RC, CRAWFORD PA.Low-carbohydrate ketogenic diets, glucose homeostasis, and nonalcoholic fatty liver disease[J].Curr Opin Clin Nutr Metab Care, 2012, 15 (4) :374-380. [62]GRATTAGLIANO I, PORTINCASA P, PALMIERI VO, et al.Managing nonalcoholic fatty liver disease:recommendations for family physicians[J].Can Fam Physician, 2007, 53 (5) :857-863. [63]ZENG MD, FAN JG, LU LG, et al.Guidelines for the diagnosis and treatment of nonalcoholic fatty liver diseases[J].J Dig Dis, 2008, 9 (2) :108-112. [64]HAN Y, SHI JP, MA AL, et al.Randomized, vitamin E-controlled trial of bicyclol plus metformin in non-alcoholic fatty liver disease patients with impaired fasting glucose[J].Clin Drug Investig, 2014, 34 (1) :1-7. [65]BELFORT R, HARRISON SA, BROWN K, et al.A placebocontrolled trial of pioglitazone in subjects with nonalcoholic steatohepatitis[J].N Engl J Med, 2006, 355 (22) :2297-2307. [66]YAN HM, XIA MF, WANG Y, et al.Efficacy of berberine in patients with non-alcoholic fatty liver disease[J].PLo S One, 2015, 10 (8) :e0134172. [67]MUSSO G, CASSADER M, ROSINA F, et al.Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD) :a systematic review and meta-analysis of randomised trials[J].Diabetologia, 2012, 55 (4) :885-904. [68]ARMSTRONG MJ, GAUNT P, AITHAL GP, et al.Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN) :a multicentre, double-blind, randomised, placebocontrolled phase 2 study[J].Lancet, 2016, 387 (10019) :679-690. [69]NEUSCHWANDER-TETRI BA, LOOMBA R, SANYAL AJ, et al.Farnesoid X nuclear receptor ligand obeticholic acid for noncirrhotic, non-alcoholic steatohepatitis (FLINT) :A multicentre, randomised, placebo-controlled trial[J].Lancet, 2015, 385 (9972) :956-965. [70]SAEZ-LARA MJ, ROBLES-SANCHEZ C, RUIZ-OJEDA FJ, et al.Effects of probiotics and synbiotics on obesity, insulin resistance syndrome, type 2 diabetes and non-alcoholic fatty liver disease:a review of human clinical trials[J].Int J Mol Sci, 2016, 17 (6) :928. -
本文二维码
计量
- 文章访问数: 478
- HTML全文浏览量: 22
- PDF下载量: 744
- 被引次数: 0
下载:
