Nonalcoholic fatty liver disease: Evolving paradigms

作     者：Amedeo Lonardo Fabio Nascimbeni Mauro Maurantonio Alessandra Marrazzo Luca Rinaldi Luigi Elio Adinolfi 

作者机构：Azienda Ospedaliero-Universitaria di ModenaOspedale Civile di Baggiovara University of Modena and Reggio Emilia Department of MedicalSurgicalNeurologicalGeriatricand Metabolic SciencesUniversity of Campania“Luigi Vanvitelli” 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第36期

页      面：6571-6592页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Nonalcoholic fatty liver disease Biomarkers Clinical correlates Diagnosis Epidemiology Genetics Liver histology Management Metabolic Syndrome Pathogenesis Screening Type 2 diabetes 

摘      要：In the last years new evidence has accumulated on nonalcoholic fatty liver disease(NAFLD)challenging the paradigms that had been holding the scene over the previous 30 *** has such an epidemic prevalence as to make it impossible to screen general population looking for NAFLD ***,focusing on those cohorts of individuals exposed to the highest risk of NAFLD could be a more rational ***,which can be diagnosed with either non-invasive strategies or through liver biopsy,is a pathogenically complex and clinically heterogeneous *** existence of metabolic as opposed to genetic-associated disease,notably includinglean NAFLDhas recently been ***,NAFLD is a systemic condition,featuring metabolic,cardiovascular and(hepatic/extrahepatic)cancer *** the clinico-laboratory features of NAFLD we discuss hyperuricemia,insulin resistance,atherosclerosis,gallstones,psoriasis and selected endocrine *** is a precursor of type 2 diabetes(T2D)and metabolic syndrome and progressive liver disease develops in T2D patients in whom the course of disease is worsened by ***,lifestyle changes and drug treatment options to be implemented in the individual patient are also critically *** conclusion,this review emphasizes the new concepts on clinical and pathogenic heterogeneity of NAFLD,a systemic disorder with a multifactorial pathogenesis and protean clinical *** is highly prevalent in certain cohorts of individuals who are thus potentially amenable to selective screening strategies,intensive follow-up schedules for early identification of liver-related and extrahepatic complications and in whom earlier and more aggressive treatment schedules should be carried out whenever possible.