Tom 14, Nr 1 (2020)
Wybrane problemy kliniczne
Opublikowany online: 2020-03-01
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Niealkoholowa stłuszczeniowa choroba wątroby (NAFLD) — etiologia, rozpoznanie, leczenie w świetle aktualnej wiedzy
Forum Medycyny Rodzinnej 2020;14(1):1-10.
Streszczenie
Niealkoholowa stłuszczeniowa choroba wątroby (NAFLD) jest jedną z najczęstszych przewlekłych chorób wątroby na świecie i dotyczy około 25% popula cji. Stanowi jedną z najczęstszych przyczyn marskości wątroby i transplantacji wątroby w Stanach Zjednoczonych. Charakteryzuje się nadmiernym gromadzeniem tłuszczów w wątrobie u osób nienadużywających alkoholu, któremu towar zyszy insulinooporność. Obejmuje dwie jed - nostki chorobowe: niealkoholowe stłuszczenie wątroby i niealkoh olowe stłuszczeniowe zapalenie wątroby. Późno rozpoznana i nieleczona może prowadzić do rozwoju marskości wątroby i raka wątroby oraz powikłań sercowo-naczyniowych. Głównymi czynnikami ryzyka NAFLD są: otyłość, zabur zenia lipidowe, cukrzyca, nadciśnienie tętnicze. W rozpoznaniu wykorzystuje się biopsję wątroby, badanie ultrasonograficzne, rezonans magnetyczny, elastografię wątroby oraz skale punktowe — NAFLD fibrosis score (NFS) i FIB-4 Index. Przebieg kliniczny NAFLD jest zazwyczaj bezobjawowy. Leczenie polega na zmianie stylu życia, interwencji dietetycznej, redukcji masy ciała, regularnej aktywności fizycznej oraz leczeniu poszczególnych czynników ryzyka. W niektórych przypadkach wskazane jest zastosowanie witaminy E i pioglitazonu w leczeniu NAFLD. L eczenie celowane NAFLD jest obecnie na etapie badań klinicznych. W artykule przedstawiono etiologię, metody diagnostyki i leczenia NAFLD w codziennej praktyce klinicznej.
Słowa kluczowe: NAFLDNASHmarskość wątrobyotyłośćcukrzyca
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