Nonalcoholic Fatty Liver Disease--The Clinician's Perspective.

摘要: Non alcoholic fatty liver (NAFLD) is a common cause of disease worldwide with prevalence ranging from 10-30%. It encompasses spectrum simple steatosis to non-alcoholic steatohepatitis (NASH) which can progress cirrhosis and hepatocellular carcinoma (HCC) in some patients. The diagnosis hepatic be made reliably by imaging. Differentiating NASH usually requires biopsy although various non-invasive methods are under evaluation. Similarly, the gold standard for staging fibrosis but NAFLD score transient elastography now validated assessment patients NAFLD. Liver should reserved at high risk having or advanced fibrosis, those needing evaluation competing diagnoses enrolled therapeutic trials. Treatment directed against pathophysiological aspects includes management obesity, insulin resistance, hyperlipidemia oxidative stress, suppression inflammation modulation gut bacteria. Lifestyle modification diet, exercise weight loss cornerstone therapy. Pharmacological treatment still evolving vitamin E pioglitazone being only approved drugs as now. Bariatric surgery lead improvement morbidly obese Optimal therapy multidisciplinary approach involving metabolic syndrome cardiovascular disease. Management related HCC like that other etiologies. Indications outcomes transplantation same etiologies