MASLD: a systemic metabolic disorder with cardiovascular and malignant complications

脂肪性肝炎 医学 脂肪肝 代谢综合征 肝硬化 疾病 内科学 肝细胞癌 慢性肝病 糖尿病 胰岛素抵抗 流行病学 胃肠病学 肝病 胰岛素 肥胖 内分泌学
作者
Giovanni Targher,Christopher D. Byrne,Herbert Tilg
出处
期刊:Gut [BMJ]
卷期号:: gutjnl-330595 被引量:291
标识
DOI:10.1136/gutjnl-2023-330595
摘要

Non-alcoholic fatty liver disease (NAFLD) has rapidly become the most common chronic liver disease globally and is currently estimated to affect up to 38% of the global adult population. NAFLD is a multisystem disease where systemic insulin resistance and related metabolic dysfunction play a pathogenic role in the development of NAFLD and its most relevant liver-related morbidities (cirrhosis, liver failure and hepatocellular carcinoma) and extrahepatic complications, such as cardiovascular disease (CVD), type 2 diabetes mellitus, chronic kidney disease, and certain types of extrahepatic cancers. In 2023, three large multinational liver associations proposed that metabolic dysfunction-associated steatotic liver disease (MASLD) should replace the term NAFLD; the name chosen to replace non-alcoholic steatohepatitis was metabolic dysfunction-associated steatohepatitis (MASH). Emerging epidemiological evidence suggests an excellent concordance rate between NAFLD and MASLD definitions—that is, ~99% of individuals with NAFLD meet MASLD criteria. In this narrative review, we provide an overview of the literature on (a) the recent epidemiological data on MASLD and the risk of developing CVD and malignant complications, (b) the underlying mechanisms by which MASLD (and factors strongly linked with MASLD) may increase the risk of these extrahepatic complications and (c) the diagnosis and assessment of CVD risk and potential treatments to reduce CVD risk in people with MASLD or MASH.
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