Die nicht-alkoholische Fettlebererkrankung: Eine Systemerkrankung

Zusammenfassung

Die nicht-alkoholische Fettlebererkrankung (NAFLD) ist die führende Lebererkrankung in der westlichen Welt und zeitgleich zentraler Bestandteil des metabolischen Syndroms. Ihr Spektrum reicht von der simplen Steatose über die nicht-alkoholische Fettleberhepatitis (NASH) und führt nicht selten in eine Fibrose mit anschließender Leberzirrhose, welche im hepatozellulären Karzinom enden kann. Dieser Progress verdeutlicht, dass die NAFLD nicht wie lange Zeit angenommen als „benigne” oder triviale Begleiterscheinung verkannt werden darf. Im Gegenteil, die NAFLD zeigt sich als eigenständiger Risikofaktor hinsichtlich der Entwicklung eines Diabetes mellitus Typ 2, Herzkreislauferkrankungen, chronischer Nephropathie und extrahepatischer Karzinome. Aufgrund dieser Zusammenhänge bedürfen NAFLD-Patienten umfassender Screeninguntersuchungen, um etwaige Entwicklungen frühzeitig zu detektieren.

Summary

Nonalcoholic fatty liver disease (NAFLD) has emerged as the leading liver disease within the Western population and it is strongly associated with obesity and the metabolic syndrome. The pathological spectrum of NAFLD comprises simple hepatic steatosis, nonalcoholic steatohepatitis (NASH) as well as liver fibrosis with consecutive development of liver cirrhosis leading to hepatocellular carcinoma (HCC; tumors with poor clinical outcome and limited therapeutic options that also can develop in non-cirrhotic livers). Thus, NAFLD can not longer be considered a benign accompanying symptom, but rather an independent risk factor for type 2 diabetes mellitus, cardiovascular disease, chronic nephropathy, and extrahepatic malignancies. Given the increasingly acknowledged pathological relevance in combination with prevalence rates that reach epidemic proportions worldwide, a more thorough diagnostic evaluation of patients suffering from NAFLD is highly desirable to prevent numerous subsequent diseases.

Schlüsselwörter

NAFLD - NASH - metabolisches Syndrom - Adipositas - chronische Nephropathie - KHK - kolorektales Karzinom

Keywords

NAFLD - NASH - metabolic syndrome - obesity - chronic nephropathy - cardiovascular disease - extrahepatic malignancies

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