与代谢功能障碍相关的脂肪性肝病的自然史和进展
Hannes Hagström1, Ying Shang2, Hannes Hegmar1
1Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
The lancet. Gastroenterology & hepatology
|September 7, 2024
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 进展到肝硬化是缓慢的,在20年内影响3-5%的患者. 本综述更新了MASLD自然史,识别了高风险患者和严重结果的缓解策略.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD),以前称为NAFLD,具有复杂的自然史.
- 虽然许多患者的病情保持稳定,但部分患者会出现炎症,纤维化和肝硬化.
- 肝硬化发生在3 - 5%的MASLD患者中,通常持续数十年.
研究的目的:
- 为 MASLD. 的自然历史提供一个更新的叙事评论.
- 讨论当前的研究和风险估计,以进展到严重的结果,如肝硬化和肝细胞癌.
- 突出识别患有疾病进展风险的患者和风险减轻策略的方法.
主要方法:
- 对现有关于MASLD自然历史的文献进行叙事审查.
- 对报告纤维化和肝硬化进展率的研究进行分析.
- 检查风险因素和潜在的缓解策略.
主要成果:
- MASLD进展为肝硬化是一个缓慢的过程,通常超过20年为3-5%的患者.
- 识别患有进展性肝损伤的患者对于及时干预至关重要.
- 潜在地可以减轻进展的风险因素,以减少不良结果.
结论:
- 了解MASLD的长期自然史对于临床管理至关重要.
- 早期识别疾病的进展和积极的风险因素管理可以改善患者的治疗结果.
- 需要进一步的研究来完善MASLD的风险分层和治疗策略.
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