Noninvasive evaluation of nonalcoholic fatty liver disease: Current evidence and practice

作     者：Jiang-Hua Zhou Jing-Jing Cai Zhi-Gang She Hong-Liang Li 

作者机构：Department of CardiologyRenmin Hospital of Wuhan UniversityInstitute of Model Animal of Wuhan University Department of CardiologyThe 3rd Xiangya Hospital of Central South University 

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

年 卷 期：2019年第25卷第11期

页      面：1307-1326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] 

基　　金：the Key Project of the National Natural Science Foundation(No.81630011,to H.L.) the National Science Fund for Distinguished Young Scholars(No.81425005,to H.L.) the Major Research Plan of the National Natural Science Foundation of China(No.91639304 and No.91729303,to H.L.) the Creative Group Project of Hubei Province(No.2016CFA010,to H.L.) the Hubei Science and Technology Support Project(No.2018BEC473,to H.L.) 

主　　题：Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Steatosis Fibrosis Noninvasive evaluation 

摘      要：With the increasing number of individuals with diabetes and obesity,nonalcoholic fatty liver disease(NAFLD) is becoming increasingly prevalent,affecting one-quarter of adults worldwide. The spectrum of NAFLD ranges from simple steatosis or nonalcoholic fatty liver(NAFL) to nonalcoholic steatohepatitis(NASH). NAFLD, especially NASH, may progress to fibrosis, leading to cirrhosis and hepatocellular carcinoma. NAFLD can impose a severe economic burden,and patients with NAFLD-related terminal or deteriorative liver diseases have become one of the main groups receiving liver transplantation. The increasing prevalence of NAFLD and the severe outcomes of NASH make it necessary to use effective methods to identify NAFLD. Although recognized as the gold standard, biopsy is limited by its sampling bias, poor acceptability, and severe complications, such as mortality, bleeding, and pain. Therefore, noninvasive methods are urgently needed to avoid biopsy for diagnosing NAFLD. This review discusses the current noninvasive methods for assessing NAFLD,including steatosis, NASH, and NAFLD-related fibrosis, and explores the advantages and disadvantages of measurement tools. In addition, we analyze potential noninvasive biomarkers for tracking disease processes and monitoring treatment effects, and explore effective algorithms consisting of imaging and nonimaging biomarkers for diagnosing advanced fibrosis and reducing unnecessary biopsies in clinical practice.