肥胖症与肝病

Obesity and liver disease

近年来肥胖症的发病率显著增加。肥胖症与多种肝病相关,尤其是非酒精性脂肪性肝病(NAFLD),后者已成为中国和西方发达国家最常见的肝病。肥胖及其相关疾病成为公共健康的一个严重威胁。内脏脂肪组织(VAT)促使单纯性脂肪变性进展到非酒精性脂肪性肝炎(NASH)。此外,肥胖是肝硬化患者失代偿的一个独立危险因素,亦似乎是肝细胞肝癌的危险因素之一。甚至在急性肝衰竭时,高体重指数(BMI)意味着更差的预后,近来的研究提示肥胖在慢性乙型和丙型肝炎的进展中亦有一定作用,肥胖是慢性丙型肝炎抗病毒治疗应答不佳的预测因素之一。

The incidence of obesity has dramatically increased in recent years. Obesity is associated with a spectrum of chronic liver disease, especially highly with nonalcoholic fatty liver disease （NAFLD）. NAFLD is becoming the most common liver disease in China and industrialized, western countries. Consequently, obesity and as- sociated disorders constitute a serious threat for public health. Visceral adipose tissue is a prominent feature in nonalcoholic steatohepatitis. Moreover, Obesity is an independent risk factor for clinical decompensation in patients with cirrhosis, and seems to be a risk factor for hepatocellular carcinoma. Even in acute liver failure, a high body mass index is associated with poor outcome, and recent data suggest a major role of obesity in the progression of chronic hepatitis C and B. Obesity is a negative prognostic factor in the treatment of chronic hepatitis C.