Enfermedad hepática grasa no alcohólica
| Autor: | B. Mateos Muñoz, R. Sánchez-Aldehuelo, A. Figueroa-Tubío, D. Burgos-Santamaría |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Gynecology
medicine.medical_specialty education.field_of_study medicine.diagnostic_test business.industry medicine.medical_treatment Population Fatty liver General Medicine Liver transplantation medicine.disease Chronic liver disease 03 medical and health sciences Liver disease 0302 clinical medicine 030220 oncology & carcinogenesis Liver biopsy Medicine 030212 general & internal medicine Metabolic syndrome Steatohepatitis business education |
| Zdroj: | Medicine - Programa de Formación Médica Continuada Acreditado. 13:173-181 |
| ISSN: | 0304-5412 |
| Popis: | espanolLa enfermedad por higado graso no alcoholico (EHGNA) es la hepatopatia cronica mas frecuente, afec-tando aproximadamente a la cuarta parte de la poblacion mundial. Se asocia al sindrome metabolico y sus ejes patogenicos son la obesidad y la resistencia a la insulina. Engloba dos entidades: la esteatosis simple (higado graso no alcoholico -HGNA-) y la esteatohepatitis no alcoholica (EHNA), esta ultima con capacidad de progresion a cirrosis, desarrollo de hepatocarcinoma (CHC) y necesidad de trasplante he-patico. Solo una minoria de los pacientes falleceran por causa hepatica; la mayoria vera condicionado su pronostico por eventos cardiovasculares y neoplasias extrahepaticas. Dada la elevada prevalencia de la enfermedad, identificar a los pacientes con riesgo de desarrollar una enfermedad hepatica avanzada es un paso critico. El grado de fibrosis es el principal factor pronostico y el diagnostico de confirmacion se realiza mediante biopsia hepatica. El tratamiento consiste en perder peso, idealmente mediante cambios en el estilo de vida a expensas de una dieta hipocalorica y ejercicio. Si este abordaje fracasa, la cirugia bariatrica es una alternativa. Aun no hay farmacos aprobados especificamente para tratar la enferme-dad. El CHC en fases precirroticas es mas frecuente que en otras etiologias de hepatopatia y su cribado mediante ecografia en esta fase es un aspecto controvertido. EnglishNon-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, affecting approximately one quarter of the world’s population. It is associated to metabolic syndrome, being obesity and insulin resistance its pathogenic axes. Two liver entities are encompassed: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). The latter may progress to cirrhosis, develop hepatocellular carcinoma (HCC) and require liver transplantation. However, a minority of patients will die due to liver disease; in most cases prognostic will depend on cardiovascular events and extrahepatic malignancies. Identifying these patients who are at risk of developing an advanced liver disease is critical. Liver fibrosis is the main prognostic factor, and liver biopsy is still considered the gold standard for the diagnosis and staging of the disease. NAFLD treatment is weight loss, ideally achieved through lifestyle modifications that include dietary caloric restriction and physical exercise. When this approach fails, bariatric surgery is an option. There are no drugs specifically approved to treat the disease. CHC in precirrotic stages is more common in NASH than in other chronic liver diseases, but its screening with abdominal ultrasound remains controversial |
| Databáze: | OpenAIRE |
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