1. Nonalcoholic fatty liver disease and hepatocellular carcinoma
- Author
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Posavec, Lana, Mikolašević, Ivana, Milić, Sandra, Licul, Vanja, and Kovač, Dražen
- Subjects
hepatocelularni karcinom ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina ,non-alcoholic fatty liver disease ,nealkoholna masna bolest jetre ,hepatocellular carcinoma ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine - Abstract
NAFLD je najčešći uzrok kronične bolesti jetre diljem svijeta, te zahvaća otprilike jednu četvrtinu populacije. U NAFLD-u dolazi do prekomjerne akumulacije masti u jetri. Uključuje čitav spektar masne bolesti jetre; u rasponu od jedonstavne steatoze do steatohepatoze pa sve to ciroze jetre i HCC-a. NAFLD se sve više prepoznaje kao jetrena manifestacija metaboličkog sindroma koji je karakteriziran abdominalnom ili centralnom pretilosti i inzulinskom rezistencijom što rezultira nastankom šećerne bolesti tipa 2, dislipidemije i hipertenzije. Koncept teorije višestrukih paralelnih udarca („Multiple-parallel hit theory“) obuhvaća više čimbenika koji djeluju zajedno u genetički predisponiranog pojedinca u nastanku NAFLD-a. Takvi „udarci“ uključuju Inzulinsku rezistenciju, lipotoksičnost, disfunkciju masnog tkiva, okolišne faktore poput prehrane, pretilosti te mikrobiote crijeva. Dijagnoza NAFLD-a je heterogena i počiva na različitim alatima za procjenu poput slikovnih metoda, jetrene biopsije te serumskih biomarkera. Povećavanjem epidemije pretilosti, prevalencija i utjecaj NAFLD-a se sve više povećava, što NASH čini potencijalno najčešći uzrokom uznapredovale bolesti jetre u nadolazećim desetljećima. Postoje indikacije da će NAFLD postati dominantni uzrok HCC-a u Zapadnim zemljama, te vodeći uzrok za transplantaciju jetre., NAFLD is the most common cause of chronic liver disease worldwide and affects around one quarter of population. NAFLD is a condition characterized by excessive fat accumulation. It includes the full spectrum of fatty liver disease; ranging from simple steatosis to steatohepatosis all the way to liver cirrhosis and HCC. NAFLD is increasingly recognized as a hepatic manifestation of metabolic syndrome characterized by abdominal or central obesity and insulin resistance resulting in the development of type 2 diabetes, dyslipidemia and hypertension. The concept of “Multiple-parallel hit theory” encompasses several factors that work together in a genetically predisposed individual that is developing NAFLD. Such "hits" include Insulin resistance, lipototoxicity, adipose tissue dysfunction, environmental factors such as diet, obesity, and intestinal microbiota. The diagnosis of NAFLD is heterogeneous and relies on a variety of assessment tools such as: imaging methods, liver biopsy, and serum biomarkers. As the obesity epidemic increases, the prevalence and impact of NAFLD is increasing simultaneously, making NASH potentially the most common cause of advanced liver disease in the coming decades. There are indications that NAFLD will become the dominant cause of HCC in Western countries and the leading cause for liver transplantation
- Published
- 2020