Research progress in the relationship between obesity and non-alcoholic fatty liver disease

doi:10.3877/cma.j.issn.2095-9605.2024.02.007

Abstract

Abstract:

The global incidence of obesity increases year by year, and the incidence of nonalcoholic fatty liver disease (NAFLD), a metabolic disease closely related to obesity, is also increasing day by day. NAFLD is one of the most common causes of chronic liver disease. Its mechanism may be related to insulin resistance, lipid metabolism disorder, oxidative stress, flora disorder and autophagy and so on. Diagnosis for NAFLD is currently dependent on liver biopsy, but relatively non-invasive and convenient serological and imaging diagnostic methods are also being more sophisticated. Studies have shown that weight loss can improve liver histological features and biochemical indicators such as blood lipids in NAFLD. At present, the basic method of weight loss is to change lifestyle, but drugs developed for weight loss are becoming increasingly diverse. At the same time, weight loss metabolic surgery has definite benefits for NAFLD, which may be one of the new indications for weight loss metabolic surgery in the future.

Key words: Obesity, Non-alcoholic fatty liver disease, Pathogenesis, Classification, Treatment, Metabolic bariatric surgery

Yuanxin Lu, Lilin Gong, Menghua Zeng. Research progress in the relationship between obesity and non-alcoholic fatty liver disease[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2024, 10(02): 113-119.

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NAS评分系统	SAF评分系统
脂肪变性等级	脂肪变性等级
肝细胞大泡性脂肪变性（包括大、小液滴）的百分比	S0：没有
肝细胞大泡性脂肪变性（包括大、小液滴）的百分比	S1：5%~33%
0：<5%	S2：34%~66%
1：5%~33%	S3：>66%
2：34%~66%
3：>66%
小叶（腺泡）炎症	小叶（腺泡）炎症
每20×物镜视野下计数	0：无
0：无	1：每20倍物镜视野≤2个病灶
1：<2个病灶	2：每20倍物镜视野>2个病灶
2：2~4个病灶
3：>4个病灶
气球样变	气球样变
0：无	0：无
1：少量	1：圆形、淡染、胞质疏松的肝细胞簇
2：大量	2：圆形、淡染、胞质疏松的肝细胞簇，且肝细胞增大（大于2倍正常肝细胞体积）
NAS（0~8）	活动等级（A，0~4级）
脂肪变性+小叶炎症+气球样变评分之和	小叶炎症和气球样变分数的总和
	A1：A＝1，轻度活动
	A2：A＝2，中度活动
	A3和A4：A>2，重度活动
纤维化分期	纤维化分期
0：无纤维化	F0：无纤维化
1a：轻微的（需要马松三色染色法辨认）小叶中央肝细胞周围纤维化	F1A：轻度3区窦周纤维化
1a：轻微的（需要马松三色染色法辨认）小叶中央肝细胞周围纤维化	FlB：中度3区窦周纤维化
1b：明显（苏木精和伊红染色可见）小叶中央肝细胞周围纤维化	F1C：仅汇管区纤维化
1b：明显（苏木精和伊红染色可见）小叶中央肝细胞周围纤维化	F2：3区和汇管区周围窦周纤维化
1c：汇管区细胞周围纤维化	F3：桥接纤维化
2：小叶中央和汇管区细胞周围纤维化	F4：肝硬化
3：桥接纤维化
4：肝硬化
SAF得分
S_0-3 A_0-4 F_0-4

NAS评分系统	SAF评分系统
脂肪变性等级	脂肪变性等级
肝细胞大泡性脂肪变性（包括大、小液滴）的百分比	S0：没有
肝细胞大泡性脂肪变性（包括大、小液滴）的百分比	S1：5%~33%
0：<5%	S2：34%~66%
1：5%~33%	S3：>66%
2：34%~66%
3：>66%
小叶（腺泡）炎症	小叶（腺泡）炎症
每20×物镜视野下计数	0：无
0：无	1：每20倍物镜视野≤2个病灶
1：<2个病灶	2：每20倍物镜视野>2个病灶
2：2~4个病灶
3：>4个病灶
气球样变	气球样变
0：无	0：无
1：少量	1：圆形、淡染、胞质疏松的肝细胞簇
2：大量	2：圆形、淡染、胞质疏松的肝细胞簇，且肝细胞增大（大于2倍正常肝细胞体积）
NAS（0~8）	活动等级（A，0~4级）
脂肪变性+小叶炎症+气球样变评分之和	小叶炎症和气球样变分数的总和
	A1：A＝1，轻度活动
	A2：A＝2，中度活动
	A3和A4：A>2，重度活动
纤维化分期	纤维化分期
0：无纤维化	F0：无纤维化
1a：轻微的（需要马松三色染色法辨认）小叶中央肝细胞周围纤维化	F1A：轻度3区窦周纤维化
1a：轻微的（需要马松三色染色法辨认）小叶中央肝细胞周围纤维化	FlB：中度3区窦周纤维化
1b：明显（苏木精和伊红染色可见）小叶中央肝细胞周围纤维化	F1C：仅汇管区纤维化
1b：明显（苏木精和伊红染色可见）小叶中央肝细胞周围纤维化	F2：3区和汇管区周围窦周纤维化
1c：汇管区细胞周围纤维化	F3：桥接纤维化
2：小叶中央和汇管区细胞周围纤维化	F4：肝硬化
3：桥接纤维化
4：肝硬化
SAF得分
S_0-3 A_0-4 F_0-4

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