Portal Hypertension in Nonalcoholic Fatty Liver Disease:From Pathogenesis to Clinical Practice
作者机构：Hepatobiliary DivisionDepartment of Internal MedicineDr Cipto Mangunkusumo National General HospitalMedical Faculty Universitas IndonesiaJakartaIndonesia Gastrointestinal Cancer CenterMRCCC Siloam Semanggi HospitalJakartaIndonesia Digestive Disease&GI Oncology CenterMedistra HospitalJakartaIndonesia
出 版 物：《Journal of Clinical and Translational Hepatology》 (临床与转化肝病杂志（英文版）)
年 卷 期：2022年第10卷第5期
页 面：979-985页
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主 题：Portal hypertension NAFLD NASH Metabolic
摘 要：Portal hypertension in nonalcoholic fatty liver disease(NAFLD)mostly occur in cirrhotic stage.However,several experimental and clinical studies showed evidence of portal hypertension in NAFLD without significant or advance fibrosis.This early development of portal hypertension in NAFLD is associated with liver sinusoidal contraction by hepatocellular lipid accumulation and ballooning,which is also accompanied by capillarization and dysfunction of liver sinusoidal endothelial cells.Both of these impaired mechanical and molecular components can cause an increase in intrahepatic vascular resistance which lead to the increase of portal pressure in the absence of significant liver fibrosis.Extrahepatic factors such as insulin resistance and gut dysbiosis may also contribute to liver sinusoidal endothelial dysfunction and early portal hypertension in NAFLD.The clinical impact of early portal hypertension in NAFLD is still unclear.However,clinical tools for diagnosis and monitoring of portal hypertension in NAFLD are being investigated to predict high-risk patients and to guide therapy.
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