非酒精性脂肪性肝病/非酒精性脂肪性肝炎循证临床实践指南

StephenW

Journal of Gastroenterology
April 2015, Volume 50, Issue 4, pp 364-377
Date: 24 Feb 2015
Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

    Sumio Watanabe, Etsuko Hashimoto, Kenichi Ikejima, Hirofumi Uto, Masafumi Ono, Yoshio Sumida, Masataka Seike, Yoshiyuki Takei, Tetsuo Takehara, Katsutoshi Tokushige, … show all 20

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Abstract

Nonalcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease in industrialized countries worldwide, and has become a serious public health issue not only in Western countries but also in many Asian countries including Japan. Within the wide spectrum of NAFLD, nonalcoholic steatohepatitis (NASH) is a progressive form of disease, which often develops into liver cirrhosis and increases the risk of hepatocellular carcinoma. In turn, a large proportion of NAFLD/NASH is the liver manifestation of metabolic syndrome, suggesting that NAFLD/NASH plays a key role in the pathogenesis of systemic atherosclerotic diseases. Currently, a definite diagnosis of NASH requires liver biopsy, though various noninvasive measures are under development. The mainstays of prevention and treatment of NAFLD/NASH include dietary restriction and exercise; however, pharmacological approaches are often necessary. Currently, vitamin E and thiazolidinedione derivatives are the most evidence-based therapeutic options, although the clinical evidence for long-term efficacy and safety is limited. This practice guideline for NAFLD/NASH, established by the Japanese Society of Gastroenterology in cooperation with The Japan Society of Hepatology, covers lines of clinical evidence reported internationally in the period starting from 1983 to January 2012, and each clinical question was evaluated using the GRADE system. Based on the primary release of the full version in Japanese, this English summary provides the core essentials of this clinical practice guideline comprising the definition, diagnosis, and current therapeutic recommendations for NAFLD/NASH in Japan.
The original version of this article appeared in Japanese as “NAFLD/NASH, Shinryo Guidelines 2014,” from the Japanese Society of Gastroenterology (JSGE), published by Nankodo, Tokyo, 2014. Please see the article on the standards, methods, and process of developing the guidelines (doi:10.1007/s00535-014-1016-1). These guidelines are published jointly in the Journal of Gastroenterology and Hepatology Research. The members of the Working Committee are listed in the Appendix in the text.

StephenW

华人消化杂志
2015年4月，第50卷，第4期，第364-377
日期：2015年2月24日
非酒精性脂肪性肝病/非酒精性脂肪性肝炎循证临床实践指南

    渡边澄夫，桥本悦子，健一池岛，弘文菟，小野雅史，雄胜美达，正孝清家，武井嘉之，竹原哲夫，德重克敏，...显示全部20

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抽象

非酒精性脂肪肝病（NAFLD）是目前慢性肝病在工业化国家中最常见的原因全世界，并且不仅在西方国家，而且在许多亚洲国家，包括日本成为一个严​​重的公共卫生问题。内NAFLD的宽谱，非酒精性脂肪性肝炎（NASH）是疾病的进行性的形式，这常常发展成肝硬化，并增加肝癌的风险。反过来，NAFLD / NASH的相当大的比例是代谢综合征的肝脏表现，这表明NAFLD / NASH起着全身动脉粥样硬化性疾病的发病机理的关键作用。目前，NASH的确诊需要肝活检，虽然各种非侵入性的措施正在制定中。预防NAFLD / NASH和治疗的支柱，包括限制饮食和锻炼;然而，药物的方法往往是必要的。目前，维生素E和噻唑烷二酮衍生物是最证据为基础的治疗方案，虽然临床证据长期疗效和安全性是有限的。这种做法准则NAFLD / NASH，由消化科的日本社会与肝病的日本文化协会合作建立的，占地面积开始在1983年至2012年1月，每个临床问题期间国际上报告的临床证据线使用GRADE评价系统。基于完整版在日本的主要版本，这个英文摘要提供了本临床实践指南，包括定义，诊断，目前的治疗建议NAFLD / NASH在日本的核心要素。
本文的原始版本出现在日本的“NAFLD / NASH，新菱准则2014年，”从消化的日本社会（JSGE），南江堂，东京，2014年出版，请参见该标准，方法和过程的文章制定准则（DOI：10.1007 / s00535-014-1016-1）。这些准则在胃肠病学和肝病研究杂志联合出版。该工作委员会的成员列在文本附录。