NONALCOHOLIC FATTY LIVER DISEASE – A MULTISYSTEM DISEASE?

Abstract

S porastom incidencije debljine i metaboličkog sindroma raste i incidencija nealkoholne masne bolesti jetre (engl. nonalcoholic fatty liver disease – NAFLD). Osim što ovi bolesnici imaju znatan rizik od progresije u terminalni stadij kronične bolesti jetre, poznato je da imaju i povećan rizik od razvoja hepatocelularnog karcinoma. S druge strane, posljednjih godina sve je veći broj publikacija koje govore u prilog tomu da NAFLD nije samo bolest ograničena na jetru, nego je udružena s nizom izvanjetrenih bolesti i stanja, a najčešće s kardiovaskularnim bolestima, kroničnom bubrežnom bolesti i šećernom bolesti tipa II. Posljedično, NAFLD je postao rastući javnozdravstveni problem. Brojni supspecijalisti, kao i liječnici obiteljske medicine trebali bi biti svjesni navedenih potencijalnih izvanjetrenih manifestacija NAFLD-a s obzirom na dostupnost brojnih metoda za probir u kliničkoj praksi. Navedeno je važno kako bi se potencijalne izvanjetrene manifestacije NAFLD-a detektirale u ranim stadijima, a time i prevenirala ili barem usporila progresija pojedinih bolesti.With the increasing incidence of obesity and metabolic syndrome the incidence of nonalcoholic fatty liver ­disease (NAFLD) is increasing as well. These patients have a significant risk of progression to the end-stage liver disease, but also these patients are at increased risk of developing hepatocellular carcinoma. In recent years there is a growing ­number of publications that support the idea that NAFLD is not just a disease that is limited to the liver, but is associated with a number of extrahepatic manifestations. For example, NAFLD increases the risk of type 2 diabetes mellitus, cardiovascular diseases and chronic kidney disease. Consequently NAFLD has become a growing public health problem. A number of sub-specialists as well as primary care physicians should be aware of these potential extrahepatic associations, given the availability of numerous methods for screening in clinical practice. The above approach is important in order to recognize potentially modifiable events in the early stages, and thus manage them and at least prevent the progression of certain diseases