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Natürlicher Verlauf

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Nicht-alkoholische Fettlebererkrankung

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Zusammenfassung

Die nicht-alkoholische Fettlebererkrankung (NAFLD) ist die häufigste chronische Lebererkrankung mit einer weltweiten Prävalenz von 20–30 %. Dabei spiegelt die Prävalenz der NAFLD den kontinuierlichen Anstieg der Adipositas weltweit wider. Histologisch reicht das Spektrum der NAFLD von einer isolierten Steatose (nicht-alkoholische Fettleber, NAFL) bis hin zur nicht-alkoholischen Steatohepatitis (NASH). In einigen Fällen zeigt sich eine Fibroseprogression bis hin zur manifesten Leberzirrhose mit einem erhöhten Risiko für ein hepatozelluläres Karzinom (HCC), welches auch in nichtzirrhotischen Lebern entstehen kann und damit eine Herausforderung für die Überwachung der hohen Anzahl an Patienten darstellt. Der natürliche Verlauf der NAFLD ist sehr variabel, wobei der entscheidende Prognosefaktor das vorliegende Fibrosestadium ist. Die NAFLD ist stark mit dem metabolischen Syndrom und dem Diabetes mellitus Typ 2 assoziiert und ein unabhängiger Risikofaktor für kardiovaskuläre Erkrankungen. Außerhalb einer fortgeschrittenen Fibrose bzw. Leberzirrhose sind kardiovaskuläre Ereignisse und extra-hepatische Malignome daher eine häufigere Todesursache als leberspezifische Komplikationen. Aus diesem Grund kommt der frühzeitigen Behandlung der metabolischen Begleiterkrankungen der NAFLD eine besondere Bedeutung als Präventionsmaßnahme zu.

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Authors and Affiliations

  1. Charité Universitätsmedizin Berlin, Berlin, Deutschland

    Münevver Demir

  2. Uniklinik Köln, Köln, Deutschland

    Hans-Michael Steffen

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  1. Münevver Demir
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  2. Hans-Michael Steffen
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Correspondence to Münevver Demir .

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Editors and Affiliations

  1. Medizinische Klinik u. Poliklinik II, Universititätsklinikum Würzburg, ZIM, Würzburg, Bayern, Deutschland

    Andreas Geier

  2. Medizinische Klinik, Universitätsklinikum Bochum GmbH, Bochum, Deutschland

    Ali Canbay

  3. Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Homburg, Saarland, Deutschland

    Frank Lammert

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Demir, M., Steffen, HM. (2022). Natürlicher Verlauf. In: Geier, A., Canbay, A., Lammert, F. (eds) Nicht-alkoholische Fettlebererkrankung. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62484-5_2

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  • DOI: https://doi.org/10.1007/978-3-662-62484-5_2

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