비알코올 지방간 질환의 역학
Epidemiology of Nonalcoholic Fatty Liver Disease
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초록
Nonalcoholic fatty liver disease (NAFLD) is recognized as the most common liver disease with an estimated prevalence of20-30% in the Western world and 16-33% in Korea. NAFLD encompasses a broad spectrum of hepatic dysfunction ranging fromnonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma. The increasingprevalence of NAFLD is particularly worrying because patients appear to have higher non-liver-related and liver-related death, ascompared to the general population. Given its well-known association with metabolic comorbidities, NAFLD is commonly associatedwith obesity, type II diabetes, dyslipidemia, and metabolic syndrome. The natural history of NAFLD remains unclear due toits indolent clinical course and the lack of well-designed prospective studies. The prognosis of NAFLD depends on the histologicalsubtype, while NASH may be associated with liver fibrosis and cirrhosis and may progress to hepatocellular carcinoma. The overalland liver-related mortality are increased in patients with NASH, as compared to NAFL and the general population. NAFLD isstrongly associated with cardiovascular disease and type 2 diabetes, so it should also be considered a metabolic liver disease. Further long-term studies of the natural course of NAFLD are warranted.
Abstract
Nonalcoholic fatty liver disease (NAFLD) is recognized as the most common liver disease with an estimated prevalence of20-30% in the Western world and 16-33% in Korea. NAFLD encompasses a broad spectrum of hepatic dysfunction ranging fromnonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma. The increasingprevalence of NAFLD is particularly worrying because patients appear to have higher non-liver-related and liver-related death, ascompared to the general population. Given its well-known association with metabolic comorbidities, NAFLD is commonly associatedwith obesity, type II diabetes, dyslipidemia, and metabolic syndrome. The natural history of NAFLD remains unclear due toits indolent clinical course and the lack of well-designed prospective studies. The prognosis of NAFLD depends on the histologicalsubtype, while NASH may be associated with liver fibrosis and cirrhosis and may progress to hepatocellular carcinoma. The overalland liver-related mortality are increased in patients with NASH, as compared to NAFL and the general population. NAFLD isstrongly associated with cardiovascular disease and type 2 diabetes, so it should also be considered a metabolic liver disease. Further long-term studies of the natural course of NAFLD are warranted.
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