therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-81563033-8344РостГМУ10.21886/2712-8156-2021-2-3-18-29therapeutic-160Research ArticleОБЗОРЫREVIEWSНеалкогольная жировая болезнь печени: современные подходы к диагностике и лечениюNon-alcoholic fatty liver disease: modern approaches to diagnosis and treatmenthttps://orcid.org/0000-0003-1510-9204КанорскийС. Г.KanorskiiS. G.

Канорский Сергей Григорьевич, д.м.н., проф., заведующий кафедрой терапии № 2 факультета повышения квалификации и профессиональной переподготовки специалистов

Краснодар

Sergey G. Kanorskii, Dr. Sci. (Med.), Professor, Head of the Department of Internal Medicine № 2 of the Faculty of Advanced Training and Professional Retraining

Krasnodar

kanorskysg@mail.ruФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава РоссииРоссияThe Kuban State Medical UniversityRussian Federation202129082021231829Copyright © Канорский С.Г., 20212021Канорский С.Г.Kanorskii S.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/160

Неалкогольная жировая болезнь печени (НАЖБП) широко распространена в популяции, является важной причиной цирроза и гепатоцеллюлярной карциномы. НАЖБП включает континуум от стеатоза через неалкогольный стеатогепатит к циррозу. НАЖБП имеет двунаправленную связь с компонентами метаболического синдрома и сахарного диабета 2 типа, увеличивая риск осложнений. Основными причинами смерти при НАЖБП являются сердечно-сосудистые заболевания и внепечёночные злокачественные новообразования, но выраженный фиброз печени — ключевой прогностический маркер, а риск смерти может оцениваться с помощью комбинации неинвазивных тестов. В настоящее время нет одобренной терапии НАЖБП, хотя несколько препаратов находятся на продвинутой стадии разработки. Проведен анализ клинических исследований, их метаанализов и обзоров литературы из баз данных PubMed и MEDLINE по 18 ключевым словам, соответствующим теме обзора, изучено более 5000 статей, опубликованных за последние годы. Обобщены современные представления об эпидемиологии, естественном течении, патогенезе, диагностике, оценке риска, профилактике и лечении НАЖБП.

Non-alcoholic fatty liver disease (NAFLD) is widespread in the population and is the leading cause of cirrhosis and hepatocellular carcinoma. NAFLD includes a continuum from steatosis to non-alcoholic steatohepatitis with rapidly progressive fibrosis. NAFLD has a bidirectional relationship with components of metabolic syndrome and type 2 diabetes, increasing the risk of complications. The main causes of death in NAFLD are cardiovascular disease and extrahepatic malignancy, but advanced liver fibrosis is a key prognostic marker, and the risk of death can be assessed using a combination of non-invasive tests. There is currently no approved therapy for NAFLD, although several drugs are in advanced stages of development. An analysis of clinical studies, their meta-analyzes and literature reviews from the PubMed and MEDLINE databases was carried out for 18 keywords corresponding to the review topic, more than 5000 articles published in recent years were studied. The current understanding of epidemiology, natural history, pathogenesis, diagnosis, risk assessment, prevention and treatment of NAFLD is summarized.

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The authors declare that there are no conflicts of interest present.