代谢和酒精相关:诊断和管理
Rahul Sandella1, Mary E Rinella2
1Department of Internal Medicine, University of Chicago Medicine, Chicago, IL, USA. Electronic address: https://twitter.com/RahulSandella.
一个新的术语,代谢性和酒精/相关性肝病,定义了超出代谢功能障碍标准但在酒精限内的脂肪性肝病. 超过这些限制将其归类为与酒精有关的肝病,需要干预.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 脂肪性肝病包括脂肪在肝脏中积累的情况.
- 代谢功能障碍相关的脂肪性肝病 (MASLD) 在满足代谢标准时被诊断出来.
- 区分代谢和酒精驱动的肝脏疾病对于有效治疗至关重要.
研究的目的:
- 引入和定义"代谢和酒精/相关性肝病" (MAL-LD) 这个术语.
- 建立清晰的酒精消费门,使MAL-LD与酒精相关肝病 (ALD) 有区别.
- 为了指导与代谢和与酒精有关的肝脏疾病重叠的患者的临床管理策略.
主要方法:
- 根据MASLD标准定义MAL-LD,并设定特定的酒精摄入门.
- 确定上限酒精摄入量:女性每天50克,男性每天60克.
- 超出这些限度的消费被描述为ALD.
主要成果:
- MAL-LD适用于符合MASLD标准但在定义的上限内饮酒的个人.
- 超过这些确定的限度的酒精消费被归类为ALD.
- 这种分类有助于区分肝病的主要驱动因素.
结论:
- 临床医生应优先考虑对疑似MAL-LD或ALD的患者进行戒酒咨询.
- 对MAL-LD患者来说,对代谢风险因素的管理至关重要.
- 对于怀疑有显著纤维化症的个人,无论主要原因如何,建议及早转诊肝病学.
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