儿童非酒精性脂肪性肝病研究的新进展

New development of study in children non-alcoholic fatty liver disease

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)指包括单纯性脂肪肝以及由其演变成的非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH),甚至肝硬化等一系列病变的综合征。肥胖和静态生活方式可诱发基因重组导致NAFLD的发生;肝脏与肠道和脂肪组织间的相互关联、基因和环境间持续的相互作用,故上述因素在儿童NAFLD的发病机制中占有重要作用。目前人们对儿童NAFLD的自然史认识不多,正逐步深入研究其发病机制。发病机制和组织学改变不仅可为早期诊断和非侵入性诊断手段的应用提供依据,还可为儿童NAFLD的诊治提供新思路。

Non-alcoholic fatty liver disease（NAFLD） is a multi-faceted disorder, which ranges from simple steatosis to non-alcoholic steatohepatitis（NASH） with/without fibrosis. The effects of specific risk factors, such as obesity and sedentary lifestyle, on predisposing genetic settings eventually lead to the development of NAFLD. The complex interplay between genes and environment in NAFLD pathogenesis is sustained by multiple mechanisms that involve liver crosstalk with other organs and tissues, especially gut and adipose tissue. Unfortunately, natural history of pediatric NAFLD is lacking, and the etiopathogenesis is still in the process of being defined. Potential early predictors and suitable non-invasive diagnostic tools can be discovered based on the pathogenetic mechanisms and histological patterns.This will also helps to design novel treatments and a comprehensive and successful management strategy for patients.