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在MASLD中疾病分类,诊断挑战和不断变化的临床试验设计

Mette Munk Lauridsen^1,2, Kim Ravnskjaer³, Lise Lotte Gluud⁴

¹Stravitz-Sanyal Liver Institute, Department of Gastroenterology & Hepatology, Virginia Commonwealth University Medical Clinic, Richmond, Virginia, USA.

The Journal of clinical investigation

|May 15, 2025

概括

与代谢功能障碍相关的脂肪性肝病 (MASLD) 需要更新诊断和管理策略. 整合非侵入性检测,多学科护理和行为因素是早期检测和更好的患者结果的关键.

科学领域:

肝病学和内分泌学.
代谢性疾病研究研究

背景情况:

与代谢功能障碍相关的脂肪性肝病 (MASLD) 的患病率正在上升,特别是在年轻人群中.
MASLD的诊断和管理正在发展,超出了传统的晚期肝病重点.
从非酒精性脂肪性肝病 (NAFLD) 改名为MASLD的目的是减少耻辱和澄清病理生理学.

研究的目的:

审查MASLD诊断和管理的不断变化的格局.
突出需要改进诊断工具和多学科合作的需要.
强调在MASLD管理中整合行为因素和初级保健.

主要方法:

审查有关MASLD诊断和管理的当前文献.
讨论非侵入性诊断测试方面的进展.
探索omics技术和行为因素的作用.

主要成果:

非侵入性测试,如肝硬度测量,对于MASLD诊断越来越重要.
奥米克技术显示出潜力,但在临床实践中未得到充分利用.
诸如PTSD和生活方式等行为因素显著影响MASLD的结果.

结论:

MASLD的管理需要转向早期检测和综合护理.
提高诊断精度,多学科合作 (尤其是内分泌学),以及整体的患者策略是必不可少的.
初级保健在早期MASLD查中发挥着至关重要的作用,以防止疾病的进展.

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