Background: Nonalcoholic fatty liver disease (NAFLD) describes a continuum of liver abnormalities from simple nonalcoholic fatty liver (NAFL) to nonalcoholic fatty liver hepatitis or steatohepatitis (NASH) to NASH fibrosis. It has a variable course, but just like alcoholic fatty liver disease, it can lead to liver cirrhosis and cancer (hepatocellular carcinoma). Summary: NAFLD is a clinical entity characterized by the presence of liver steatosis, which affects at least 5% of hepatocytes. Affected are people who consume little or no alcohol and who have no secondary cause of liver steatosis such as viral hepatitis, drug intake (e.g., tamoxifen, amiodarone, methotrexate, etc.), or lipodystrophy. NAFLD is, nowadays, the most common liver disease in Europe, with an estimated prevalence of 25%. The currently widely recognized recommendation for the therapy of NAFLD is a lifestyle modification with the goal of weight loss. Although no drugs are currently approved for the treatment of NAFLD, several candidates are in clinical trials. Besides weight loss and physical activity, corresponding single active ingredients or combination therapies are intended to stop the progression of the disease and, in the best case, reverse it. The newly propagated name MAFLD (metabolic-associated fatty liver disease) should indicate that the disease is associated with metabolic disorders. The term MAFLD also implies multiple overlapping causes and drivers of this soaring disease. Key Messages: The prevalence of NAFLD continues to rise worldwide. NAFLD, NASH, and fibrosis in NAFLD occur predominantly in patients with obesity and type 2 diabetes (T2DM) or else precede these conditions. The progression of NAFLD is highly dependent on changes in glucose, lipid metabolism, and fibrogenesis. A new definition and nomenclature of fatty liver disease, “metabolic associated fatty liver disease” (MAFLD), should be discussed carefully, since around 40% of the global population with NAFLD are classified as non-obese and almost 1/5 as lean. Since the pathogenesis of fatty liver disease, obesity, and glucose and lipid metabolism diseases are very closely related, it is important to continue to look for mechanisms that these diseases have in common and develop new therapeutic approaches.
Visc Med

中文翻译：

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体重超标和代谢（功能障碍）相关脂肪肝病 (MAFLD)


背景：非酒精性脂肪性肝病（NAFLD）描述了从单纯性非酒精性脂肪肝（NAFL）到非酒精性脂肪性肝炎或脂肪性肝炎（NASH）到NASH纤维化的一系列肝脏异常。它的病程各不相同，但就像酒精性脂肪肝一样，它可以导致肝硬化和癌症（肝细胞癌）。摘要： NAFLD 是一种临床实体，其特征是存在肝脏脂肪变性，影响至少 5% 的肝细胞。受影响的人很少或不饮酒，并且没有肝脏脂肪变性的继发性原因，例如病毒性肝炎、药物摄入（例如他莫昔芬、胺碘酮、甲氨蝶呤等）或脂肪营养不良。 NAFLD 是当今欧洲最常见的肝脏疾病，估计患病率为 25%。目前广泛认可的 NAFLD 治疗建议是以减肥为目标的生活方式改变。尽管目前还没有药物被批准用于治疗 NAFLD，但有几种候选药物正在进行临床试验。除了减肥和体力活动之外，相应的单一活性成分或联合疗法旨在阻止疾病的进展，并在最好的情况下逆转疾病。新传播的名称MAFLD（代谢相关脂肪肝病）应该表明该疾病与代谢紊乱有关。 MAFLD 一词还意味着这种疾病飙升的多种重叠原因和驱动因素。关键信息： NAFLD 的患病率在全球范围内持续上升。 NAFLD、NASH 和 NAFLD 中的纤维化主要发生在肥胖和 2 型糖尿病 (T2DM) 患者中，或者先于这些疾病发生。 NAFLD 的进展高度依赖于葡萄糖、脂质代谢和纤维发生的变化。脂肪肝病的新定义和命名法“代谢相关脂肪肝病”(MAFLD) 应该仔细讨论，因为全球约 40% 的 NAFLD 患者属于非肥胖人群，近 1/5 属于瘦体重人群。由于脂肪肝、肥胖以及糖脂代谢疾病的发病机制密切相关，因此继续寻找这些疾病的共同机制并开发新的治疗方法非常重要。
 内脏医学