代谢相关脂肪性肝病

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中国第一大慢性肝病,正在透支年轻人
虎嗅APP· 2025-07-05 10:00
Core Viewpoint - The article discusses the rising prevalence of non-alcoholic fatty liver disease (NAFLD) in China, particularly among young adults, and highlights the associated health risks and lifestyle factors contributing to this condition [3][4][7]. Group 1: Prevalence and Demographics - NAFLD has overtaken viral hepatitis as the leading chronic liver disease in China, with the prevalence of non-alcoholic fatty liver disease reaching 21.36% by 2021 [7][10]. - A study from Wuhan University indicates that the overall prevalence of NAFLD in China approached 30% from 1999 to 2018, suggesting that nearly 3 out of 10 individuals may be affected [10]. - The disease disproportionately affects the obese population, with approximately two-thirds of obese individuals diagnosed with NAFLD [11]. - Alarmingly, about 40% of NAFLD patients globally are not obese, and in China, nearly a quarter of non-obese individuals are also affected [12][13]. - The incidence of NAFLD among young adults aged 20-24 increased by 18.34% from 2011 to 2021, the highest growth rate across all age groups [16]. Group 2: Causes and Mechanisms - The root cause of NAFLD is metabolic dysfunction rather than just dietary habits, as the liver becomes overloaded with excess fat due to metabolic disturbances [18][19]. - The latest medical guidelines have redefined NAFLD as "metabolism-related fatty liver disease," emphasizing the connection between metabolic disorders and liver health [20]. - Conditions such as obesity, high blood lipids, and diabetes significantly increase the risk of developing NAFLD, with individuals exhibiting metabolic syndrome having over four times the risk compared to the general population [20][23]. Group 3: Health Risks and Complications - NAFLD is linked to increased risks of cardiovascular diseases, with over half of NAFLD patients also facing atherosclerosis [31]. - The risk of extrahepatic malignancies, including thyroid cancer and other gastrointestinal cancers, is significantly elevated in NAFLD patients, with the incidence of non-liver cancers reaching approximately 10.58 cases per 1,000 individuals [37]. - The mortality rates from liver cirrhosis and liver cancer due to NAFLD have been rising, with cirrhosis mortality increasing from 0.36 to 0.45 per 100,000 and liver cancer mortality more than doubling from 0.35 to 0.73 per 100,000 between 1990 and 2021 [25]. Group 4: Lifestyle Interventions - Weight loss of 3% to 5% can effectively reduce liver fat accumulation, while a 5% to 7% reduction can significantly lower liver inflammation [38]. - A combination of dietary changes, such as reducing sugar and fat intake, along with regular physical activity, is essential for managing and potentially reversing NAFLD [39]. - Individuals diagnosed with NAFLD often experience a cycle of anxiety and lifestyle regression, emphasizing the need for sustained lifestyle changes to prevent further health deterioration [39].