Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9544110.26442/20751753.2021.4.200887ArticlesСтатьиReview ArticleObesity and non-alcoholic fatty liver disease: cardiometabolic risks and their correctionОжирение и неалкогольная жировая болезнь печени: кардиометаболические риски и их коррекцияKomshilovaKseniya A.КомшиловаКсения Андреевна

канд. мед. наук, врач-эндокринолог

kom-ksusha@rambler.ruMazurinaNatalya V.МазуринаНаталия Валентиновна

канд. мед. наук, вед. науч. сотр.

ErshovaEkaterina V.ЕршоваЕкатерина Владимировна

канд. мед. наук, вед. науч. сотр.

TroshinaEkaterina A.ТрошинаЕкатерина Анатольевна

чл.-кор. РАН, д-р мед. наук, проф., зам. дир.

Endocrinology Research CentreФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России15042021234VOL 23, NO4 (2021)ТОМ 23, №4 (2021)33233728122021Copyright ©; 2021, Consilium MedicumCopyright ©; 2021, ООО "Консилиум Медикум"2021Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/95441

Non-alcoholic fatty liver disease (NAFLD) is the common chronic disease, associated with obesity, especially abdominal obesity, and a metabolic syndrome, that considerably raises cardiometabolic risk and is reflected in morbidity, prognosis of the disease and life expectancy of patients. NAFLD at the stage of steatosis does not increase the risk of mortality in the general population, however, the potentially dangerous stage, non-alcoholic steatohepatitis, in many cases remains unrecognized in a timely manner and, in the absence of adequate treatment, can progress and lead to the development of cirrhosis, liver failure, and hepatocellular carcinoma. The issues of NAFLD treatment are relevant due to the high prevalence of obesity, diabetes mellitus type 2, cardiovascular diseases and their complications. NAFLD therapy should be aimed primarily at the etiopathogenetic factors that contribute to its development and progression, as well as the correction of associated metabolic disorders. The growing prevalence of obesity, NAFLD and associated risk factors, diagnostic difficulties and the lack of an algorithm for managing such patients confirm the urgency of this problem. In this article describes the basic mechanisms of pathogenesis NAFLD, its role in obesity, prognosis of the disease, diagnostics and treatment.

Неалкогольная жировая болезнь печени (НАЖБП) - распространенное хроническое заболевание печени, тесно ассоциированное с ожирением, особенно абдоминальным, и метаболическим синдромом, что значительно повышает кардиометаболический риск и отражается на заболеваемости, прогнозе и продолжительности жизни больных. НАЖБП на стадии стеатоза не повышает риск смертности в общей популяции, однако потенциально опасная стадия - неалкогольный стеатогепатит - во многих случаях остается своевременно не распознанной и в отсутствие адекватного лечения может прогрессировать и приводить к развитию цирроза, печеночной недостаточности и гепатоцеллюлярной карциномы. Вопросы лечения НАЖБП в настоящее время приобрели особую актуальность в связи с высокой распространенностью ожирения, сахарного диабета типа 2, кардиоваскулярных заболеваний и их осложнений. Терапия НАЖБП должна быть направлена в первую очередь на этиопатогенетические факторы, способствующие ее развитию и прогрессированию, а также коррекцию ассоциированных метаболических нарушений. Растущая распространенность ожирения, НАЖБП и связанных с ними факторов риска, трудности диагностики и отсутствие общепринятого алгоритма ведения таких больных еще раз подтверждают актуальность данной проблемы. В статье изложены основные механизмы патогенеза НАЖБП, ее роль при ожирении, прогноз заболевания, диагностика и лечение.

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