Die Versorgung der nicht-alkoholischen Fettlebererkrankung (NAFLD) in der allgemeinmedizinischen Praxis gestaltet sich trotz ihrer hohen Prävalenz oft schwierig. Die Krankheit ist symptomarm, und eine spezifische Medikation ist bisher nicht zugelassen. Hausärzte spielen in der hauptsächlich auf Lebensstilmaßnahmen basierenden Therapie eine wichtige Rolle.
Literatur
Eslam M, Newsome PN, Sarin SK et al. A new definition for metabolic associated fatty liver disease: an international expert consensus statement. J Hepatol 2020, online 8. April; doi: https://doi.org/10.1016/j.jhep.2020.03.039
Roeb E et al. S2K Leitlinie nicht alkoholische Lebererkrankungen. Z Gastroenterol. 2015;53:668–723
EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64:1388–402
Estes C et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol. 2018;69:896–904
Stahl EP et al. Nonalcoholic fatty liver disease and the heart. J Am Coll Cardiology. 2019;75:948–63
Alexander M et al. Non-alcoholic fatty liver disease and risk of incident acute myocardial infarction and stroke: findings from matched cohort study of 18 million European adults. BMJ. 2019;367:l5367
Targher G et al. Increased prevalence of cardiovascular disease in Type 2 diabetic patients with non-alcoholic fatty liver disease Diabetic Med. 2006;23:403–9
Bril F, Cusi K. Nonalcoholic fatty liver disease: the new complication of type 2 diabetes mellitus. Endocrinol Metab Clin North Am. 2016;45:765–81
Angulo P et al. Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology. 2015;149:389–97
Taylor RS et al. Association between fibrosis stage and outcomes of patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis. Gastroenterology. 2020;158:1611–25.e12
Mofrad P et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology. 2003;37:1286–92
Parker C et al. Magnetic resonance elastography vs transient elastography in detection of fibrosis and non-invasive measurement of steatosis in patients with biopsy-proven nonalcoholic fatty liver disease. Gastroenterology. 2017;152:598–607
Chalasani N et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67:328–57
Singh S et al. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13:643–54
Grgurevic I et al. Natural history of nonalcoholic fatty liver disease: Implications for clinical practice and an individualized approach. Can J Gastroenterol Hepatol. 2020;21:1–10
Romero-Gomez M et al. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol. 2017;67:829–46
Ajmera V et al. Among patients with nonalcoholic fatty liver disease, modest alcohol use is associated with less improvement in histologic steatosis and steatohepatitis. Clin Gastroenterol Hepatol. 2018;16:1511–20
Chen YP et al. A systematic review and a dose—response meta-analysis of coffee dose and nonalcoholic fatty liver disease. Clin Nutr. 2019;38:2552–7
Cusi K et al. Long-term Pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus: a randomized trial. Ann Intern Med. 2016;165:305–15
Dhir G et al. Glucagon like peptide-1 receptor agonists for the management of obesity and non-alcoholic fatty liver disease: a novel therapeutic option. J Investig Med. 2018;66:7–10
Younossi ZM et al. Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial. Lancet. 2019;394:2184–96
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schulte-Frohlinde, E. Die verfettete Leber in der Hausarztpraxis. MMW - Fortschritte der Medizin 162, 58–60 (2020). https://doi.org/10.1007/s15006-020-0618-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15006-020-0618-1