期刊
WORLD JOURNAL OF GASTROENTEROLOGY
卷 20, 期 27, 页码 9072-9089出版社
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v20.i27.9072
关键词
Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Liver cirrhosis; Hepatocellular cancer; Dysfunctional adipose tissue; Type 2 diabetes mellitus; Insulin resistance; Obesity; Genetics; Therapy
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that might affect up to one-third of the adult population in industrialised countries. NAFLD incorporates histologically and clinically different non-alcoholic entities; fatty liver (NAFL, steatosis hepatis) and steatohepatitis (NASH-characterised by hepatocyte ballooning and lobular inflammation +/- fibrosis) might progress to cirrhosis and rarely to hepatocellular cancer. NAFL increasingly affects children (paediatric prevalence is 4.2%-9.6%). Type 2 diabetes mellitus (T2DM), insulin resistance (IR), obesity, metabolic syndrome and NAFLD are particularly closely related. Increased hepatic lipid storage is an early abnormality in insulin resistant women with a history of gestational diabetes mellitus. The accumulation of triacylglycerols in hepatocytes is predominantly derived from the plasma nonesterified fatty acid pool supplied largely by the adipose tissue. A few NAFLD susceptibility gene variants are associated with progressive liver disease, IR, T2DM and a higher risk for hepatocellular carcinoma. Although not approved, pharmacological approaches might be considered in NASH patients. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
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