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| 1 | Liver fibrosis in non-alcoholic fatty liver disease-diagnostic challenge with prognostic significance显示文摘Non-alcoholic fatty liver disease(NAFLD) is the mostcommon liver disease in the Western world, with a prevalence of 20%. In a subgroup of patients, inflammation, ballooning degeneration of hepatocytes and a varying degree of fibrosis may develop, a condition named non-alcoholic steatohepatitis. Advanced liver fibrosis(stage F3) and cirrhosis(stage F4) are histologic features that most accurately predict increased mortality in both liver-related and cardiovascular diseases. Patients with advanced fibrosis or cirrhosis are at risk for complications such as hepatocellular carcinoma and esophageal varices and should therefore be included in surveillance programs. However, liver disease and fibrosis are often unrecognized in patients with NAFLD, possibly leading to a delayed diagnosis of complications. The early diagnosis of advanced fibrosis in NAFLD is therefore crucial, and it can be accomplished using serum biomarkers(e.g., the NAFLD Fibrosis Score, Fib-4 Index or BARD) or non-invasive imaging techniques(transient elastography or acoustic radiation force impulse imaging). The screening of risk groups, such as patients with obesity and/or type 2 diabetes mellitus, for NAFLD development with these non-invasive methods may detect advanced fibrosis at an early stage. Additionally, patients with a low risk for advanced fibrosis can be identified, and the need for liver biopsies can be minimized. This review focuses on the diagnostic challenge and prognostic impact of advanced liver fibrosis in NAFLD. | Per Stal | 2015 | World Journal of Gastroenterology2015，21，39： | 15 |
| 2 | Insulin resistance in development and progression of nonalcoholic fatty liver disease显示文摘Although insulin resistance(IR)is strongly associated with nonalcoholic fatty liver disease(NAFLD),the association of IR and NAFLD is not universal and correlation between IR and severity of NAFLD is still controversial.In this review,we summarize recent evidence that partially dissociates insulin resistance from NAFLD.It has also been reported that single-nucleotide polymorphisms in the diacylglycerol acyltransferase gene,rather than IR,account for the variability in liver fat content.Polymorphisms of the patatin-like phospholipase 3 gene have also been reported to be associated with NAFLD without metabolic syndrome,which suggests that genetic conditions that promote the development of fatty changes in the liver may occur independently of IR.Moreover,environmental factors such as nutrition and physical activity as well as small intestinal bacterial overgrowth have been linked to the pathogenesis of NAFLD,although some of the data are conflicting.Therefore,findings from both genetically engineered animal models and humans with genetic conditions,as well as recent studies that have explored the role of environmental factors,have confirmed the view that NAFLD is a polygenic disease process caused by both genetic and environmental factors.Therefore,IR is not the sole predictor of the pathogenesis of NAFLD. | Shahinul Alam Golam Mustafa Mahabubul Alam Nooruddin Ahmad | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，2： | 12 |
| 3 | Endocrine causes of nonalcoholic fatty liver disease显示文摘Nonalcoholic fatty liver disease(NAFLD) is the most common cause of chronic liver disease in the industrialized world. The prevalence of NAFLD is increasing, becoming a substantial public health burden. NAFLD includes a broad spectrum of disorders, from simple conditions such as steatosis to severe manifestations such as fibrosis and cirrhosis. The relationship ofNAFLD with metabolic alterations such as type 2 diabetes is well described and related to insulin resistance, with NAFLD being recognized as the hepatic manifestation of metabolic syndrome. However, NAFLD may also coincide with endocrine diseases such as polycystic ovary syndrome, hypothyroidism, growth hormone deficiency or hypercortisolism. It is therefore essential to remember, when discovering altered liver enzymes or hepatic steatosis on radiological exams, that endocrine diseases can cause NAFLD. Indeed, the overall prognosis of NAFLD may be modified by treatment of the underlying endocrine pathology. In this review, we will discuss endocrine diseases that can cause NALFD. Underlying pathophysiological mechanisms will be presented and specific treatments will be reviewed. | Laura Marino Francois R Jornayvaz | 2015 | World Journal of Gastroenterology2015，21，39： | 11 |
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