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Neues zur nichtalkoholischen Steatohepatitis

New aspects of nonalcoholic steatohepatitis

  • Schwerpunkt: Stoffwechselerkrankungen
  • Published:
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Zusammenfassung

In den vergangenen zehn Jahren ist die nichtalkoholische Fettlebererkrankung (NAFLD) vermehrt in den Fokus der klinischen Forschung gerückt. Der Begriff NAFLD beinhaltet die einfache nichtalkoholische Steatose oder Fettleber (NAFL) und die nichtalkoholische Steatohepatitis (NASH). Da die Inzidenz der NAFLD stark angestiegen ist, geht man davon aus, dass in den nächsten Jahren vor allem die NASH in vielen industrialisierten Ländern die Hauptursache für die Lebertransplantation sein wird. Weiterhin beobachtet man zunehmend, dass ein zirrhotischer Umbau der Leber direkt und ohne das Durchlaufen des Stadiums der NASH aus der NAFL entstehen kann. Schließlich erhärten sich die Hinweise, dass einerseits sowohl die NAFL als auch die NASH mit einem stark erhöhten Risiko für das Auftreten von Typ-2-Diabetes und kardiovaskulären Erkrankungen einhergeht und andererseits die NAFL und NASH Komplikationen des Diabetes darstellen. Im vorliegenden Beitrag werden aktuelle Erkenntnisse zur Prävalenz, Diagnose, Risikovorhersage und Therapie der NAFLD dargelegt und diskutiert.

Abstract

During the past 10 years nonalcoholic fatty liver disease (NAFLD) has moved more and more into the focus of attention of clinical research. The term NAFLD comprises the simple nonalcoholic steatosis or fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). As the incidence of NAFLD has dramatically increased, it is expected that during the coming years NASH in particular will become the main reason for liver transplantation in industrialized countries. In addition, it has become evident that scirrhotic liver fibrosis can develop directly from NAFL without going through the stage of NASH. Finally, there is accumulating evidence that both NAFL and NASH are strongly associated with an increased risk of type 2 diabetes and cardiovascular diseases and on the other hand that NAFL and NASH are complications of diabetes. This article addresses the current knowledge about the prevalence, diagnosis, risk prediction and treatment of NAFLD.

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Authors and Affiliations

  1. Abteilung für Innere Medizin IV, Bereiche Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland

    N. Stefan

  2. Abteilung für Pathophysiologie des Prädiabetes, Institut für Diabetesforschung und Metabolische Erkrankungen (IDM), Helmholtz Zentrum München, Universität Tübingen, Tübingen, Deutschland

    N. Stefan

  3. Harvard Medical School, Boston, MA, USA

    N. Stefan

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Correspondence to N. Stefan.

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N. Stefan gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Redaktion

H. Lehnert, Lübeck

C.C. Sieber, Nürnberg

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Stefan, N. Neues zur nichtalkoholischen Steatohepatitis. Internist 60, 128–132 (2019). https://doi.org/10.1007/s00108-018-0550-y

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  • DOI: https://doi.org/10.1007/s00108-018-0550-y

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