NASH: A global health problem

Hepatology Research - Tập 41 Số 7 - Trang 670-674 - 2011
Arun J. Sanyal1
1Department of Pharmacology and Molecular Pathology, Virginia Commonwealth University, Richmond, Virginia, USA.

Tóm tắt

Non‐alcoholic fatty liver disease (NAFLD) is a major public health problem both in the Western world and in the East. This is mainly due to the high prevalence of the disease and its effects on the individual with NAFLD. In the USA, it is estimated that approximately a third of the general population has NAFLD. Increasing age, obesity and the presence of multiple features of metabolic syndrome, especially diabetes, are associated with a higher probability of having non‐alcoholic steatohepatitis (NASH). In the individual with NAFLD, excess hepatic fat is associated with an increased risk of developing diabetes, hypertension, cardiovascular events, abnormal resting electrocardiography and endothelial dysfunction. These findings have been corroborated in studies in teenagers as well as adults. There is also an increase in cardiovascular mortality, especially in those with NASH. In addition, there is an increased risk of death from a variety of non‐hepatocellular cancers. From a liver perspective, NAFLD is associated with a 15–20% risk of progression to cirrhosis. The disease progresses more rapidly in those with diabetes, increasing age and obesity. The PNPLA3 gene mutation at position 148 is associated with not only steatosis, but with the likelihood of having steatohepatitis and increased inflammation and fibrosis. Once cirrhosis develops, the liver disease decompensates at the rate of 3–4% per year. NASH‐related cirrhosis is a risk factor for hepatocellular cancer. All of these factors indicate that NAFLD is a common condition that has significant adverse health consequences for those who are afflicted. It is therefore a major public health hazard throughout the world

Từ khóa


Tài liệu tham khảo

Ludwig J, 1980, Nonalcoholic steatohepatitis: mayo clinic experiences with a hitherto unnamed disease, Mayo Clin Proc, 55, 434

10.1016/S0016-5085(99)70506-8

10.1002/hep.20701

10.1038/nrgastro.2010.21

10.1053/jhep.2002.30692

10.1016/S0002-9343(99)00271-5

10.1001/jama.285.19.2486

10.2337/dc07-1030

10.1001/jama.287.3.356

10.4158/EP.9.S2.5

10.1007/s00535-009-0198-4

10.1097/MEG.0b013e32832fcdf0

10.1016/S0168-8278(01)00151-9

10.1002/hep.20734

10.1053/gast.2002.35354

10.1148/rg.291075123

10.1002/hep.20466

10.1111/j.1572-0241.2003.07486.x

10.1002/hep.1840120505

10.1097/00007890-200006150-00034

10.1038/ajg.2010.152

10.1016/j.cld.2004.04.010

Watanabe T, 2005, Metabolic syndrome from the view point of public health: with special reference to nonalcoholic fatty liver disease, Nippon Koshu Eisei Zasshi, 52, 934

10.1089/met.2009.0062

10.7326/0003-4819-132-2-200001180-00004

10.1002/hep.23527

10.1016/j.cgh.2009.09.005

10.1111/j.1572-0241.2003.07640.x

10.1002/hep.22134

10.1074/jbc.M109.064501

10.1097/MOL.0b013e328338ca61

10.1002/hep.23768

10.1053/j.gastro.2005.04.014

10.2337/dc07-0349

10.1185/03007995.2010.506375

Thông tin
Thông tin xuất bản

Hepatology Research

Tập 41 Số 7

670-674

Thông tin tác giả