Неалкогольна жирова хвороба печінки: поширеність, природний перебіг, сучасні підходи до діагностики та лікування

С. М. Ткач, Т. Л. Чеверда

Анотація


У лекції розглянуто основні причини та фактори ризику, патогенез, поширеність та звичайний перебіг НАЖХП, що є печінковим проявом метаболічного синдрому. Представлено критерії встановлення діагнозу НАЖХП, діагностичні можливості різних інвазивних та неінвазивних методів, сучасні підходи до ведення хворих. Автори дійшли висновку, що сучасне лікування НАЖХП має враховувати всі наявні фактори ризику та включати п’ять голoвних складових: модифікацію способу життя, вплив на компоненти метаболічного синдрому, гепатопротекторну терапію, модифікацію кишкової мікробіоти та лікування ускладнень цирозу. 


Ключові слова


неалкогольна жирова хвороба печінки; неалкогольний стеатогепатит; поширеність; діагностика; лікування

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Abu-Shanab A, Quigley EM. The role of the gut microbiota in nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol 2010;7(12):691-701. https://doi.org/10.1038/nrgastro.2010.172

Aller R, De Luis DA, Izaola O, Conde R, Gonzalez Sagrado M,Primo D, et al. Effect of a probiotic on liver aminotransferases in nonalcoholic fatty liver disease patients: a double blind randomized clinical trial. Eur Rev Med Pharmacol Sci 2011; 15(9):1090-5.

Anstee QM, Targher G, Day CP. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nat Rev Gastroenterol Hepatol 2013;10:330–44. https://doi.org/10.1038/nrgastro.2013.41

Anstee QM, McPherson S, Day CP. How big a problem is non-alcoholic fatty liver disease? BMJ 2011;343:d3897.https://doi.org/10.1136/bmj.d3897

Arcidiacono B, Iiritano S, Nocera A, et al. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res 2012; 2012: 789174. https://doi.org/10.1155/2012/789174

Armstrong MJ, Houlihan DD, Bentham L, et al. Presence and severity of non-alcoholic fatty liver disease in a large prospective primary care cohort. J Hepatol 2012;56:234–40. https://doi.org/10.1016/j.jhep.2011.03.020

Armstrong MJ, Houlihan DD, Rowe IA, et al. Safety and efficacy of liraglutide in patients with type 2 diabetes and elevated liver enzymes: individual patient data meta-analysis of the LEAD program. Aliment Pharmacol Ther 2013;37:234–42. https://doi.org/10.1111/apt.12149

Ascha MS, Hanouneh IA, Lopez R, et al. The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis. Hepatology 2010;51:1972–8. https://doi.org/10.1002/hep.23527

Boettcher E, Csako G, Pucino F, et al. Meta-analysis: pioglitazone improves liver histology and fibrosis in patients with non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2012;35:66–75. https://doi.org/10.1111/j.1365-2036.2011.04912.x

Caldwell S, Argo C. The natural history of non-alcoholic fatty liver disease. Dig Dis 2010; 28: 162-168 [PMID: 20460906] https://doi.org/10.1159/000282081

Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology 2012;142:1592–609. https://doi.org/10.1053/j.gastro.2012.04.001

Chen HP, Shieh JJ, Chang CC, et al. Metformin decreases hepatocellular carcinoma risk in a dose-dependent manner: population-based and in vitro studies. Gut 2013;62:606–15. https://doi.org/10.1136/gutjnl-2011-301708

Collier JD, Ninkovic M, Compston JE. Guidelines on the management of osteoporosis associated with chronic liver disease. Gut 2002;50(Suppl 1): 1–9. https://doi.org/10.1136/gut.50.suppl_1.i1

Comparea D., Coccoli a P., Roccoa A., Nardonea O.M., De Mariab S., Cartenıb M., Nardonea G. Gute-liver axis: The impact of gut microbiota on nonalcoholic fatty liver disease. Nutrition, Metabolism & Cardiovascular Diseases (2012) 22, 471-476https://doi.org/10.1016/j.numecd.2012.02.007

Day CP. Pathogenesis of steatohepatitis. Best Pract Res Clin Gastroenterol 2002; 16: 663-678 [PMID: 12406438]https://doi.org/10.1053/bega.2002.0333

D’Albuquerque LA, Gonzalez AM, Wahle RC, et al. Liver transplantation for subacute hepatocellular failure due to massive steatohepatitis after bariatric surgery. Liver Transpl 2008;14:881–5.https://doi.org/10.1002/lt.21472

Dixon JB, Bhathal PS, O’Brien PE. Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology 2001; 121(1): 91-100. https://doi.org/10.1053/gast.2001.25540

Donadon V, Balbi M, Ghersetti M, et al. Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic liver disease. World J Gastroenterol 2009;5:2506–11. https://doi.org/10.3748/wjg.15.2506

Dyson JK, McPherson S, Anstee QM. Non-alcoholic fatty liver disease: non-invasive investigation and risk stratification. J Clin Pathol 2013;66:1033–45. https://doi.org/10.1136/jclinpath-2013-201620

Dyson Jessica K, Anstee Quentin M, McPherson Stuart. Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging. Frontline Gastroenterol 2014; 5: 211-218. https://doi.org/10.1136/flgastro-2013-100403

Ekstedt M, Franzen LE, Mathiesen UL, et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology 2006;44:865–73. https://doi.org/10.1002/hep.21327

El-Serag HB, Johnson ML, Hachem C, et al. Statins are associated with a reduced risk of hepatocellular carcinoma in a large cohort of patients with diabetes. Gastroenterology 2009;136:1601–8. https://doi.org/10.1053/j.gastro.2009.01.053

Floch MH. The power of poop: probiotics and fecal microbial transplant. J Clin Gastroenterol 2012; 46: 625-626 [PMID: 22874805. https://doi.org/10.1097/mcg.0b013e3182667a93 ]

Garcia-Tsao G, Sanyal AJ, Grace ND, et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology 2007;46:922–38.https://doi.org/10.1002/hep.21907

Harrison SA, Fecht W, Brunt EM, et al. Orlistat for overweight subjects with nonalcoholic steatohepatitis: a randomized, prospective trial. Hepatology 2009;49:80–6.https://doi.org/10.1002/hep.22575

Hassan MM, Curley SA, Li D, et al. Association of diabetes duration and diabetes treatment with the risk of hepatocellular carcinoma. Cancer 2010;116:1938–46. https://doi.org/10.1002/cncr.24982

Henao-Mejia J, Elinav E, Jin C, et al. Inflammasome-mediated dysbiosis regulates progression of NAFLD and obesity. Nature 2012; 482(7384): 179-85. https://doi.org/10.1038/nature10809

Lavine JE, Schwimmer JB, Van Natta ML, et al. Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents: the TONIC randomized controlled trial. JAMA 2011;305:1659–68. https://doi.org/10.1001/jama.2011.520

Law K, Brunt EM. Nonalcoholic fatty liver disease. Clin Liver Dis 2010;14(4):591-604. https://doi.org/10.1016/j.cld.2010.07.006

Li Z, Yang S, Lin H, Huang J, Watkins PA, Moser AB, et al. Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease. Hepatology 2003;37(2):343-50. https://doi.org/10.1053/jhep.2003.50048

Machado MV, Coutinho J, Carepa F, et al. How adiponectin, leptin, and ghrelin orchestrate together and correlate with the severity of nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 2012; 24(10): 1166-72. https://doi.org/10.1097/meg.0b013e32835609b0

Machado MV, Cortez-Pinto H. Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal. J Hepatol 2013;58:1007–19. https://doi.org/10.1016/j.jhep.2012.11.021

Mummadi RR, Kasturi KS, Chennareddygari S, et al. Effect of bariatric surgery on nonalcoholic fatty liver disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol 2008;6:1396–402. https://doi.org/10.1016/j.cgh.2008.08.012

Malaguarnera M, Vacante M, Antic T, et al. Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis. Dig Dis Sci 2012; 57(2): 545-53. https://doi.org/10.1007/s10620-011-1887-4

Ma X, Hua J, Li Z. Probiotics improve high fat diet-induced hepatic steatosis and insulin resistance by increasing hepatic NKT cells. J Hepatol 2008;49(5):821-30. https://doi.org/10.1016/j.jhep.2008.05.025

Miele L, Marrone G, Lauritano С, Cefalo C, Gasbarrini A et al. Gut-liver Axis and Microbiota in NAFLD: Insight Pathophysiology for Novel Therapeutic Target. Current Pharmaceutical Design, 2013, Vol. 19: 34-46 https://doi.org/10.2174/1381612811319290011

Musso G, Gambino R, Cassader M, et al. A meta-analysis of randomized trials for the treatment of nonalcoholic fatty liver disease. Hepatology 2010; 52(1): 79-104. https://doi.org/10.1002/hep.23623

Nardone G, Rocco A. Probiotics: a potential target for the prevention and treatment of steatohepatitis. J Clin Gastroenterol 2004;38(Suppl. 6):S121-2.

Newsome PN, Allison ME, Andrews PA, et al. Guidelines for liver transplantation for patients with non-alcoholic steatohepatitis. Gut 2012;61:484–500. https://doi.org/10.1136/gutjnl-2011-300886

NICE. NICE clinical guidelines. CG87 Type 2 diabetes: The management of type 2 diabetes. In: NICE, ed., 2010.

Ong JP, Pitts A, Younossi ZM. Increased overall mortality and liver-related mortality in nonalcoholic fatty liver disease. J Hepatol 2008; 49: 608-12. https://doi.org/10.1016/j.jhep.2008.06.018

Parker HM, Johnson NA, Burdon CA, et al. Omega-3 supplementation and non-alcoholic fatty liver disease: a systematic review and meta-analysis. J Hepatol 2012;56:944–51. https://doi.org/10.1016/j.jhep.2011.08.018

Parnell JA, Raman M, Rioux KP, Reimer RA. The potential role of prebiotic fibre for treatment and management of nonalcoholic fatty liver disease and associated obesity and insulin resistance. Liver Int; 2011 Dec 30. https://doi.org/10.1111/j.1478-3231.2011.02730.x

Promrat K, Kleiner DE, Niemeier HM, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology 2010;51:121–9. https://doi.org/10.1002/hep.23276

Ryan MC, Itsiopoulos C, Thodis T, et al. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol 2013;59:138–43. https://doi.org/10.1016/j.jhep.2013.02.012

Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. NEJM 2010;362:1675–85. https://doi.org/10.1056/nejmoa0907929

Shanab AA, Scully P, Crosbie O, et al. Small intestinal bacterial overgrowth in nonalcoholic steatohepatitis: association with toll-like receptor 4 expression and plasma levels of interleukin 8. Dig Dis Sci 2011; 56(5): 1524-34 https://doi.org/10.1007/s10620-010-1447-3

Singh S, Singh PP, Singh AG, et al. Statins Are AssociatedWith a Reduced Risk of Hepatocellular Cancer: a Systematic Review and Meta-analysis. Gastroenterology 2013;144:323–32. https://doi.org/10.1053/j.gastro.2012.10.005

Thoma C, Day CP, Trenell MI. Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: a systematic review. J Hepatol 2012;56:255–66. https://doi.org/10.1016/j.jhep.2011.06.010

Tilg H, Moschen AR. Evolution of inflammation in nonalcoholic fatty liver disease: the multiple parallel hits hypothesis. Hepatology 2010;52(5):1836-46. https://doi.org/10.1002/hep.24001

Vanni E, Bugianesi E. The gut-liver axis in nonalcoholic fatty liver disease: Another pathway to insulin resistance? Hepatology. 2009; 49(6): 1790-2. https://doi.org/10.1002/hep.23036

Vrieze A, Van Nood E, Holleman F, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology 2012; 143(4): 913-6. https://doi.org/10.1053/j.gastro.2012.06.031

Williams CD, Stengel J, Asike MI, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology 2011; 140(1): 124-31. https://doi.org/10.1053/j.gastro.2010.09.038

Younossi М Z. Changes in the Prevalence of the Most Common Causes of Chronic Liver Diseases in the United States From 1988 to 2008. Clinical Gastroenterology and Hepatology 2011;6:524-530 https://doi.org/10.1016/j.cgh.2011.03.020

Zhang F, Luo W, Shi Y, Fan Z, Ji G. Should we standardize the 1,700-year-old fecal microbiota ransplantation? Am J Gastroenterol 2012; 107: 1755; author reply p.1755-p.1756 [PMID: 23160295 https://doi.org/10.1038/ajg.2012.251]


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DOI: https://doi.org/10.24026/1818-1384.1(53).2016.75839

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