提高对非酒精性脂肪性肝病的认识,早期防治代谢紊乱

非酒精性脂肪性肝病(NAFLD)十分常见,在普通人群中患病率为10%～24%,在糖尿病人群中高达70%～80%,近年来在亚太地区和我国呈上升趋势,我国上海城市社区人群中NAFLD患病率已达15%.大量研究表明NAFLD是代谢综合征在肝脏的表现,NAFLD不仅与代谢综合征密切伴随,而且还可预测2型糖尿病和心血管疾病的发生.由于肝脏是调节和控制糖脂代谢的中枢器官,肝脏脂肪沉积在代谢紊乱相关疾病的发病中起着关键作用.对专科医生尤其是内分泌科医生来说,认识到NAFLD与糖尿病和心血管疾病的密切关系至关重要.对NAFLD应该及早正确诊断,并且及时评估这些患者糖尿病和心血管疾病的风险,这对于预防糖尿病和心血管疾病具有重要意义.

Approach to the pathogenesis of nonalcoholic fatty liver disease for early diagnosis and treatment of metabolic disorders

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder, affecting 10%-24% of the general population, and the incidence is much higher (70% -80% ) in type 2 diabetic patients. Recent studies indicate that fatty liver is an emerging problem in the Asia-Pacific region and China. The community prevalence of NAFLD in Shanghai is 15%. A large body of evidences suggests that NAFLD is the hepatic manifestation of the metabolic syndrome. NAFLD is not only associated with the metabolic syndrome, it also predicts the development of type 2 diabetes and cardiovascular disease (CVD). The liver is a central organ for controlling and regulating glucose and lipids metabolism; intrahepatocellular lipid accumulation plays a key role in the development of metabolic-ally related disorders. It is crucial that specialists, especially endocrinologists, and practising clinicians should be aware of the strong association between NAFLD and increased risks of diabetes and CVD, NAFLD should be diagnosed correctly and defined timely in regarding its role as risk factors of underlying diabetes and CVD.