Consensus document. Management of non-alcoholic fatty liver disease (NAFLD). Clinical practice guideline

被引：87

作者：

Aller, Rocio ^{[1
,2
]}

Fernandez-Rodriguez, Conrado ^{[3
]}

lo Iacono, Oreste ^{[4
]}

Banares, Rafael ^{[5
]}

Abad, Javier ^{[6
]}

Antonio Carrion, Jose ^{[7
]}

Garcia-Monzon, Carmelo ^{[8
]}

Caballeria, Joan ^{[9
]}

Berenguer, Marina ^{[10
]}

Rodriguez-Peralvarez, Manuel ^{[11
]}

Lopez Miranda, Jose ^{[11
]}

Vilar-Gomez, Eduardo ^{[12
]}

Crespo, Javier ^{[13
]}

Garcia-Cortes, Miren ^{[14
]}

Reig, Maria ^{[9
]}

Maria Navarro, Jose ^{[15
]}

Gallego, Rocio ^{[12
]}

Genesca, Joan ^{[16
]}

Teresa Arias-Loste, Maria ^{[13
,17
]}

Jesus Pareja, Maria ^{[17
]}

Albillos, Agustin ^{[18
]}

Muntane, Jordi ^{[19
]}

Jorquera, Francisco ^{[20
,21
]}

Sola, Elsa ^{[9
]}

Hernandez-Guerra, Manuel ^{[22
]}

Angel Rojo, Miguel ^{[1
,2
]}

Salmeron, Javier ^{[23
]}

Caballeria, Llorenc ^{[24
]}

Diago, Moises ^{[25
]}

Molina, Esther ^{[26
]}

Bataller, Ramon ^{[27
]}

Romero-Gomez, Manuel ^{[12
]}

机构：

[1] Univ Valladolid, Fac Med, Hosp Clin Univ Valladolid, Serv Gastroenterol, Valladolid, Spain

[2] Univ Valladolid, Fac Med, Ctr Invest Endocrinol & Nutr, Valladolid, Spain

[3] Univ Rey Juan Carlos, Fac Med, Hosp Univ Fdn Alcorcon, Serv Gastroenterol, Madrid, Spain

[4] Hosp Tajo, Serv Aparato Digest, Madrid, Spain

[5] Hosp Gregorio Maranon, Serv Gastroenterol & Hepatol, Madrid, Spain

[6] Hosp Puerta de Hierro, Serv Gastroenterol & Hepatol, Madrid, Spain

[7] Hosp Mar, Serv Digest, Unidad Hepat, Barcelona, Spain

[8] Hosp Univ Santa Cristina, Serv Med Interna, Madrid, Spain

[9] Hosp Clin Barcelona, CIBERehd, IDIBAPS, Unidad Hepatol, Barcelona, Spain

[10] Hosp La Fe, Serv Med Digest, Valencia, Spain

[11] Hosp Reina Sofia, UGC Aparato Digest, Unidad Trasplante Hepat, Cordoba, Spain

[12] Univ Seville, Hosp Univ Virgen del Rocio, Inst Biomed Sevilla, UGC Aparato Digest,CIBERehd, Seville, Spain

[13] Univ Cantabria, Hosp Univ Marques de Valdecilla, Serv Aparato Digest, CIBERehd,Inst Invest Valdecilla IDIVAL, Santander, Spain

[14] Hosp Virgen de la Victoria, UGC Aparato Digest, Malaga, Spain

[15] Hosp Costa Sol, Serv Digest, Unidad Hepatol, Malaga, Spain

[16] Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Serv Med Interna Hepatol, Inst Recerca Vail dHebron VHIR,CIBERehd, Barcelona, Spain

[17] Hosp Juan Ramon Jimenez, UGC Aparato Digest, Huelva, Spain

[18] Univ Alcala, Hosp Univ Ramon & Cajal, Serv Gastroenterol & Hepatol, IRYCS,CIBERehd, Madrid, Spain

[19] Univ Seville, Hosp Univ Virgen del Rocio, UGC Cirugia Gen & Aparato Digest, Inst Biomed Sevilla,CSIC,CIBERehd, Seville, Spain

[20] Complejo Asistencial Univ Leon, Serv Aparato Digest, IBIOMED, Leon, Spain

[21] CIBERehd, Leon, Spain

[22] Hosp Univ Canarias, Serv Digest, Tenerife, Islas Canarias, Spain

[23] Hosp San Cecilio, UGC Aparato Digest, Granada, Spain

[24] Unidad Apoyo Invest Atenc Primaria Metropolitana, Barcelona, Spain

[25] Hosp Gen Valencia, Serv Aparato Digest, Valencia, Spain

[26] Hosp Clin Xerencia Xest Integrada Santiago de Com, Serv Aparato Digest, Unidad Hepatol, La Coruna, Spain

[27] Univ Pittsburg, Med Ctr, Liver Unit, Pittsburg, KS USA

来源：

GASTROENTEROLOGIA Y HEPATOLOGIA | 2018年 / 41卷 / 05期

关键词：

Non-alcoholic fatty liver disease; Diagnosis; Treatment; Clinical guidelines; Recommendations; Steatosis; Fibrosis; Cardiovascular risk; AMERICAN-GASTROENTEROLOGICAL-ASSOCIATION; INCREASED INTESTINAL PERMEABILITY; HIGH PROTEIN/LOW CARBOHYDRATE; ENDOPLASMIC-RETICULUM STRESS; LIFE-STYLE MODIFICATION; LONG-TERM OUTCOMES; HEPATOCELLULAR-CARCINOMA; INSULIN-RESISTANCE; BARIATRIC SURGERY; CARDIOVASCULAR RISK;

D O I：

10.1016/j.gastrohep.2017.12.003

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Non-alcoholic fatty liver disease (NAFLD) is the main cause of liver diseases in Spain and the incidence is raising due to the outbreak of type 2 diabetes and obesity. This CPG suggests recommendation about diagnosis, mainly non-invasive biomarkers, and clinical management of this entity. Life-style modifications to achieve weight toss is the main target in the management of NAFLD. Low caloric Mediterranean diet and 200 minutes/week of aerobic exercise are encouraged. In non-responders patients with morbid obesity, bariatric surgery or metabolic endoscopy could be indicated. Pharmacological therapy is indicated in patients with NASH and fibrosis and non-responders to weight loss measures. NAFLD could influence liver transplantation, as a growing indication, the impact of steatosis in the graft viability, de novo NAFLD rate after OLT and a raised cardiovascular risk that modify the management of this entity. The current CPG was the result of the First Spanish NAFLD meeting in Seville. (C) 2018 Elsevier Espana, S.L.U. All rights reserved.

引用

页码：328 / 349

页数：22

共 176 条

[1] Alimentary regimen in non-alcoholic fatty liver disease: Mediterranean diet [J].

Abenavoli, Ludovico ;

Milic, Natasa ;

Peta, Valentina ;

Alfieri, Francesco ;

De Lorenzo, Antonino ;

Bellentani, Stefano .

WORLD JOURNAL OF GASTROENTEROLOGY, 2014, 20 (45) :16831-16840

[2] Excess risk of primary liver cancer in patients with diabetes mellitus [J].

Adami, HO ;

Chow, WH ;

Nyren, O ;

Berne, C ;

Linet, MS ;

Ekbom, A ;

Wolk, A ;

McLaughlin, JK ;

Fraumeni, JF .

JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1996, 88 (20) :1472-1477

[3] Additive impact of pre-liver transplant metabolic factors on survival post-liver transplant [J].

Adams, Leon A. ;

Arauz, Oscar ;

Angus, Peter W. ;

Sinclair, Marie ;

MacDonald, Graeme A. ;

Chelvaratnam, Utti ;

Wigg, Alan J. ;

Yeap, Sze ;

Shackel, Nicholas ;

Lin, Linda ;

Raftopoulos, Spiro ;

McCaughan, Geoffrey W. ;

Jeffrey, Gary P. .

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2016, 31 (05) :1016-1024

[4] Liver Transplantation for Nonalcoholic Steatohepatitis The New Epidemic [J].

Agopian, Vatche G. ;

Kaldas, Fady M. ;

Hong, Johnny C. ;

Whittaker, Meredith ;

Holt, Curtis ;

Rana, Abbas ;

Zarrinpar, Ali ;

Petrowsky, Henrik ;

Farmer, Douglas ;

Yersiz, Hasan ;

Xia, Victor ;

Hiatt, Jonathan R. ;

Busuttil, Ronald W. .

ANNALS OF SURGERY, 2012, 256 (04) :624-633

[5] Lipotoxicity pathways intersect in hepatocytes: Endoplasmic reticulum stress, c-Jun N-terminal kinase-1, and death receptors [J].

Akazawa, Yuko ;

Nakao, Kazuhiko .

HEPATOLOGY RESEARCH, 2016, 46 (10) :977-984

[6] The Development of the Pediatric NAFLD Fibrosis Score (PNFS) to Predict the Presence of Advanced Fibrosis in Children with Nonalcoholic Fatty Liver Disease [J].

Alkhouri, Naim ;

Mansoor, Sana ;

Giammaria, Paola ;

Liccardo, Daniela ;

Lopez, Rocio ;

Nobili, Valerio .

PLOS ONE, 2014, 9 (08)

[7] Development and validation of a new histological score for pediatric non-alcoholic fatty liver disease [J].

Alkhouri, Naim ;

De Vito, Rita ;

Alisi, Anna ;

Yerian, Lisa ;

Lopez, Rocio ;

Feldstein, Ariel E. ;

Nobili, Valerio .

JOURNAL OF HEPATOLOGY, 2012, 57 (06) :1312-1318

[8] Metabolomic Identification of Subtypes of Nonalcoholic Steatohepatitis [J].

Alonso, Cristina ;

Fernandez-Ramos, David ;

Varela-Rey, Marta ;

Martinez-Arranz, Ibon ;

Navasa, Nicolas ;

Van Liempd, Sebastiaan M. ;

Lavin Trueba, Jose L. ;

Mayo, Rebeca ;

Ilisso, Concetta P. ;

de Juan, Virginia G. ;

Iruarrizaga-Lejarreta, Marta ;

delaCruz-Villar, Laura ;

Minchole, Itziar ;

Robinson, Aaron ;

Crespo, Javier ;

Martin-Duce, Antonio ;

Romero-Gomez, Manuel ;

Sann, Holger ;

Platon, Julian ;

Van Eyk, Jennifer ;

Aspichueta, Patricia ;

Noureddin, Mazen ;

Falcon-Perez, Juan M. ;

Anguita, Juan ;

Aransay, Ana M. ;

Luz Martinez-Chantar, Maria ;

Lu, Shelly C. ;

Mato, Jose M. .

GASTROENTEROLOGY, 2017, 152 (06) :1449-+

[9] The functions of animal microRNAs [J].

Ambros, V .

NATURE, 2004, 431 (7006) :350-355

[10] Liver Fibrosis, but No Other Histologic Features, Is Associated With Long-term Outcomes of Patients With Nonalcoholic Fatty Liver Disease [J].

Angulo, Paul ;

Kleiner, David E. ;

Dam-Larsen, Sanne ;

Adams, Leon A. ;

Bjornsson, Einar S. ;

Charatcharoenwitthaya, Phunchai ;

Mills, Peter R. ;

Keach, Jill C. ;

Lafferty, Heather D. ;

Stahler, Alisha ;

Haflidadottir, Svanhildur ;

Bendtsen, Flemming .

GASTROENTEROLOGY, 2015, 149 (02) :389-+

← 1 2 3 4 5 6 7 8 9 10 →