《代谢相关（非酒精性）脂肪性肝病防治指南（2024年版）》解读

孔嘉宁; 张彬彬; 施军平

doi:10.12449/JCH240908

《代谢相关（非酒精性）脂肪性肝病防治指南（2024年版）》解读

DOI: 10.12449/JCH240908

1.
杭州师范大学临床医学院，杭州 310015
2.
杭州师范大学附属医院感染与肝病科，杭州师范大学肝病与代谢病研究所，杭州 310015

基金项目:

国家科技重大专项 (2023ZD0508704);

国家自然科学基金 (82204827);

浙江省基础公益研究项目 (LQ23H27016)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：孔嘉宁、张彬彬负责撰写论文，施军平负责文章审校。

详细信息

通信作者:
施军平， 20131004@hznu.edu.cn （ORCID： 0000-0001-9434-897X）

计量
- 文章访问数: 1561
- HTML全文浏览量: 1126
- PDF下载量: 715
- 被引次数: 0
出版历程
- 收稿日期: 2024-08-31
- 录用日期: 2024-09-18
- 出版日期: 2024-09-25

An excerpt of clinical practice guideline of prevention and treatment of metabolic dysfunction-associated （non-alcoholic） fatty liver disease （2024 edition）

1.
Clinical Medicine College，Hangzhou Normal University，Hangzhou 310015，China
2.
Department of Infectious Diseases and Hepatology，The Affiliated Hospital of Hangzhou Normal University；Institute of Hepatology and Metabolic Diseases，Hangzhou Normal University，Hangzhou 310015，China

Research funding:

The National Major Science and Technology Program (2023ZD0508704);

National Natural Science Foundation of China (82204827);

Zhejiang Provincial Public Welfare Research Project (LQ23H27016)

More Information

Corresponding author: SHI Junping， 20131004@hznu.edu.cn （ORCID： 0000-0001-9434-897X）

摘要

摘要: 随着对非酒精性脂肪性肝病（NAFLD）研究的进一步深入，新证据、新理念和新方法的不断出现，中华医学会肝病学分会以国内外脂肪性肝病最新研究进展为依据，在既往指南基础上进行了全面更新和修订，发布了《代谢相关（非酒精性）脂肪性肝病防治指南（2024年版）》。本文介绍了新版指南在相关术语［代谢相关脂肪性肝病（MAFLD）］、临床分型分期、诊断标准以及自然史等方面的更新。新版指南尤其强化了进展性肝纤维化的筛查、评估、无创诊断在MAFLD疾病管理中的重要性，对MAFLD多学科团队协作管理也更为积极。随着新版指南的推行与应用，将进一步提升我国MAFLD患者的筛查、诊断、治疗和随访等方面的规范化，以改善广大患者的预后。
- 非酒精性脂肪性肝病 /
- 预防 /
- 治疗 /
- 指南
Abstract: With further in-depth studies on non-alcoholic fatty liver disease （NAFLD）， new evidence， concepts， and methods continue to emerge. Chinese Society of Hepatology， Chinese Medical Association， comprehensively updated and revised the previous guidelines based on the latest research advances in fatty liver disease in China and globally and released Clinical practice guideline of prevention and treatment of metabolic dysfunction-associated （non-alcoholic） fatty liver disease （2024 edition）. This article introduces the updates in the new edition of the guideline from the aspects of related terms （metabolic associated fatty liver disease ［MAFLD］）， clinical typing and staging， diagnostic criteria， and natural history. The guideline particularly emphasizes the importance of screening， assessment， and noninvasive diagnosis of progressive liver fibrosis in disease management and proposes active multidisciplinary collaboration in the management of MAFLD. With the implementation and application of the new edition of the guideline， the standardization of screening， diagnosis， treatment and follow-up of MAFLD patients in China will be further improved to improve the prognosis of the majority of patients.
- Non-alcoholic Fatty Liver Disease /
- Prevention /
- Treatment /
- Guideline

HTML全文

参考文献(12)

[1]	NDUMELE CE, RANGASWAMI J, CHOW SL, et al. Cardiovascular-kidney-metabolic health: A presidential advisory from the American heart association[J]. Circulation, 2023, 148( 20): 1606- 1635. DOI: 10.1161/cir.0000000000001184.
[2]	ESLAM M, SARIN SK, WONG VWS, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease[J]. Hepatol Int, 2020, 14( 6): 889- 919. DOI: 10.1007/s12072-020-10094-2.
[3]	NAN YM, AN JH, BAO JF, et al. The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease[J]. J Hepatol, 2021, 75( 2): 454- 461. DOI: 10.1016/j.jhep.2021.05.003.
[4]	Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of metabolic dysfunction-associated(non-alcoholic)fatty liver disease(Version 2024)[J]. J Prac Hepatol, 2024, 27( 4): 494- 510. DOI: 10.3760/cma.j.cn501113-20240327-00163. 中华医学会肝病学分会. 代谢相关(非酒精性)脂肪性肝病防治指南(2024年版)[J]. 实用肝脏病杂志, 2024, 27( 4): 494- 510. DOI: 10.3760/cma.j.cn501113-20240327-00163.
[5]	RINELLA ME, LAZARUS JV, RATZIU V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature[J]. Ann Hepatol, 2024, 29( 1): 101133. DOI: 10.1016/j.aohep.2023.101133.
[6]	National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association, Fatty Liver Expert Committee, Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: A 2018 update[J]. J Clin Hepatol, 2018, 34( 5): 947- 957. DOI: 10.3969/j.issn.1001-5256.2018.05.007. 中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34( 5): 947- 957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.
[7]	SANYAL AJ, VAN NATTA ML, CLARK J, et al. Prospective study of outcomes in adults with nonalcoholic fatty liver disease[J]. N Engl J Med, 2021, 385( 17): 1559- 1569. DOI: 10.1056/nejmoa2029349.
[8]	KARIM MA, SINGAL AG, KUM HC, et al. Clinical Characteristics and Outcomes of Nonalcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma in the United States[J]. Clin Gastroenterol Hepatol, 2023, 21( 3): 670- 680. DOI: 10.1016/j.cgh.2022.03.010.
[9]	DUELL PB, WELTY FK, MILLER M, et al. Nonalcoholic fatty liver disease and cardiovascular risk: A scientific statement from the American heart association[J]. Arterioscler Thromb Vasc Biol, 2022, 42( 6): e168- e185. DOI: 10.1161/ATV.0000000000000153.
[10]	LYNCH GM, MURPHY CH, DE MARCO CASTRO E, et al. Inflammation and metabolism: The role of adiposity in sarcopenic obesity[J]. Proc Nutr Soc, 2020, 79( 4): 435- 447. DOI: 10.1017/s0029665120007119.
[11]	MANTOVANI A, PETRACCA G, BEATRICE G, et al. Non-alcoholic fatty liver disease and risk of incident diabetes mellitus: an updated meta-analysis of 501 022 adult individuals[J]. Gut, 2021, 70( 5): 962- 969. DOI: 10.1136/gutjnl-2020-322572.
[12]	RINELLA ME. Nonalcoholic fatty liver disease: A systematic review[J]. JAMA, 2015, 313( 22): 2263- 2273. DOI: 10.1001/jama.2015.5370.