Журнал "Медицинский совет. Терапия" №6 2018
К.А. Комшилова, к.м.н., Е.А. Трошина, чл.-корр. РАН, д.м.н., профессор Национальный медицинский исследовательский центр эндокринологии Минздрава России, Москва
Неалкогольная жировая болезнь печени (НАЖБП) – это распространенное хроническое заболевание печени, основным признаком которого является накопление жира в гепатоцитах, не связанное со злоупотреблением алкоголем. НАЖБП ассоциирована с ожирением, особенно абдоминальным, метаболическим синдромом и различными метаболическими маркерами риска развития сердечно-сосудистых заболеваний и сахарного диабета 2-го типа, что отражается на заболеваемости, прогнозе и продолжительности жизни больных ожирением. В данной статье изложены основные причины заболевания, его патогенез, клиническая картина, диагностика и лечение.
K.A. Komshilova, PhD in medicine, Е.А. Troshina, Corr. Member of RAS, MD, Prof. National Medical Research Center of Endocrinology of the Ministry of Health of Russia, Moscow
Obesity and non-alcoholic fatty liver disease personalized approaches to metabolic risks correction
Nonalcoholic fatty liver disease (NAFLD) – a common chronic disease of the liver, the main feature of which is the accumulation of fat in hepatocytes, is not related to alcohol abuse. NAFLD is associated with obesity, especially abdominal, metabolic syndrome and various metabolic markers of risk for cardiovascular disease and type 2 diabetes, which affects the incidence, prognosis and life expectancy of patients with obesity. This lecture describes the main causes of the disease, its pathogenesis, clinical presentation, diagnosis and treatment.
Список литературы
1. Буеверов А.О. Хронические заболевания печени. Краткое руководство для практикующих врачей. Издательство «МИА», 2013. С. 144.
2. Adams L, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgraduate medical Journal, 2006, 82: 315-22.
3. Armstrong M.J., Hull D., Guo K. et al. Glucagon-like peptide 1 decreases lipotoxicity in nonalcoholic steatohepatitis. J Hepatol, 2016 Feb 21, 64(2):399-408. Epub 2015 Sep 21.
4. Armstrong MJ, Gaunt P, Aithal GP, Barton D, Hull D, Parker R et al. Liraglutide safety and efficacy in patients with nonalcoholic steatohepatitis (LEAN): a multicentre, doubleblind, randomised, placebo-controlled phase 2 study. Lancet, 2016, 387(10019): 679-90.
5. Armstrong MJ, Houlihan DD, Rowe IA, Clausen WH, Elbrond B, Gough SC et al. Safety and efficacy of liraglutide in patients with type 2 diabetes and elevated liver enzymes: individual patient data meta-analysis of the LEAD program. Aliment Pharmacol Ther, 2013, 37(2): 234-42.
6. Chalasani N, Younossi Z, Lavine JE, et al. The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol, 2012, 107: 811-26.
7. Dowman JK, Tomlinson JW, Newsome PN. Pathogenesis of non-alcoholic fatty liver disease. QJM, 2010, 103(2): 71-83.
8. EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Journal of Hepatology, 2016, 64: 1388-1402. doi: 10.1016/j.jhep.2015.11.004.
9. Targher G, et al. Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease. N Engl J Med, 2010, 363: 1341-50.
10. Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, Ferrell LD, Liu YC, Torbenson MS, Unalp-Arida A, Yeh M, McCullough AJ, Sanyal AJ. Nonalcoholic Steatohepatitis Clinical Research Network. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology, 2005 Jun, 41(6): 1313-21.
11. Lau E, Carvalho D, Freitas P. Gut microbiota: association with NAFLD and metabolic disturbances. BMRI, 2015, 2015: Article ID 979515.
12. Lazo M, Clark J. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis, 2008, 28(4): 339-50.
13. Marchesini G, Bianchi G, Tomassetti S, Zoli M, Melchionda N. Metformin in non-alcoholic steatohepatitis. The Lancet, 2001, 358(9285): 893-4.
14. Musso G, Gambino R., Cassader M. Nonalcoholic fatty liver disease from pathogenesis to management: an update. Obesity Reviews, 2010, 11(6): 430-45.
15. Nair S, Diehl A, Wiseman M. Metformin in the triement of non- alcoholic steatohepatitis: a pilot open label trial. Aliment Pharmacol Ther, 2004, 20: 23-8.
16. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty iver disease and nonalcoholic steatohepatitis in adults. Aliment Pharmacol Ther, 2011, 34: 274-285.
