Non-alcoholic fatty liver disease and type 2 diabetes mellitus: The liver disease of our age?

作者：Firneisz Gabor^*

来源：World Journal of Gastroenterology, 2014, 20(27): 9072-9089.

DOI：10.3748/wjg.v20.i27.9072

• Non-alcoholic fatty liver disease
• Non-alcoholic steatohepatitis
• Liver cirrhosis
• Hepatocellular cancer
• Dysfunctional adipose tissue
• Type 2 diabetes mellitus
• Insulin resistance
• Obesity
• Genetics
• Therapy

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that might affect up to one-third of the adult population in industrialised countries. NAFLD incorporates histologically and clinically different non-alcoholic entities; fatty liver (NAFL, steatosis hepatis) and steatohepatitis (NASH-characterised by hepatocyte ballooning and lobular inflammation +/- fibrosis) might progress to cirrhosis and rarely to hepatocellular cancer. NAFL increasingly affects children (paediatric prevalence is 4.2%-9.6%). Type 2 diabetes mellitus (T2DM), insulin resistance (IR), obesity, metabolic syndrome and NAFLD are particularly closely related. Increased hepatic lipid storage is an early abnormality in insulin resistant women with a history of gestational diabetes mellitus. The accumulation of triacylglycerols in hepatocytes is predominantly derived from the plasma nonesterified fatty acid pool supplied largely by the adipose tissue. A few NAFLD susceptibility gene variants are associated with progressive liver disease, IR, T2DM and a higher risk for hepatocellular carcinoma. Although not approved, pharmacological approaches might be considered in NASH patients.

• 出版日期2014-7-21