Der Internist

, Volume 48, Issue 2, pp 154–163 | Cite as

Nichtalkoholische Fettleber und Steatohepatitis

Schwerpunkt: Metabolisches Syndrom

Zusammenfassung

Die nichtalkoholische Fettlebererkrankung (NAFLD) und die nichtalkoholische Steatohepatitis (NASH) werden als hepatische Manifestation des metabolischen Syndroms angesehen. Da die Prävalenz von Übergewicht und damit des metabolischen Syndroms in der westlichen Welt stetig zunimmt, gelten die verschiedenen Formen der nichtalkoholischen Fettlebererkrankung mittlerweile als häufigste Lebererkrankung in den USA. Die Entwicklung einer nichtalkoholischen Steatohepatitis bis hin zu einer möglichen Fettleberzirrhose folgt einer „Zwei-Schritt-Theorie“, bei der nach der Entwicklung einer Steatosis die Vorgänge der Lipidperoxidation, Zytokinproduktion und Induktion von Fas-Ligand wesentliche pathogenetische Mechanismen darstellen. Etablierte medikamentöse Behandlungsoptionen bestehen zur Zeit nicht. Glitazone deuten sich jedoch als mögliche Behandlungsoption an. Da die Erkrankungen Folgen eines westlichen Lebensstils sind, sollten therapeutische Ansätze präventive Maßnahmen und Änderungen der Lebensgewohnheiten beinhalten.

Schlüsselwörter

Nichtalkoholische Fettleber Nichtalkoholische Fettleberhepatitis Steatohepatitis Metabolisches Syndrom Reaktive Sauerstoffspezies 

Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis

Abstract

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are the hepatic manifestations of the metabolic syndrome. Since the prevalence of obesity and consequently of the metabolic syndrome is steadily increasing, the different types of NAFLD are nowadays the most common cause of liver injury in North America. The development of NASH and fatty liver cirrhosis occurs after a “two-hit-theory”, in which hepatic steatosis is followed by lipid peroxidation, the production of cytokines and the induction of Fas ligand. A standardized drug based therapy does not exist so far, but glitazones have emerged as a promising treatment option. However, since the disease is related to Western lifestyle, treatment should be based on prevention and changes in lifestyle.

Keywords

Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Steatohepatitis Metabolic syndrome Reactive oxygen species 
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Notes

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

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Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Medizinische Klinik und Poliklinik IIUniversitätsklinikum LeipzigLeipzigDeutschland

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