PDF(Pubmed)
Abstract：
Nonalcoholic fatty liver disease (NAFLD) is a term describing excessive accumulation of fat in hepatocytes, and is associated with metabolic syndrome and insulin resistance. NAFLD prevalence is on increase and goes in parallel with the increasing prevalence of metabolic syndrome and its components. That is why Croatian guidelines have been developed, which cover the screening protocol for patients with NAFLD risk factors, and the recommended diagnostic work-up and treatment of NAFLD patients. NAFLD screening should be done in patients with type 2 diabetes mellitus, or persons with two or more risk factors as part of metabolic screening, and is carried out by noninvasive laboratory and imaging methods used to detect fibrosis. Patient work-up should exclude the existence of other causes of liver injury and determine the stage of fibrosis as the most important factor in disease prognosis. Patients with initial stages of fibrosis continue to be monitored at the primary healthcare level with the management of metabolic risk factors, dietary measures, and increased physical activity. Patients with advanced fibrosis should be referred to a gastroenterologist/hepatologist for further treatment, monitoring, and detection and management of complications.
摘要：
非酒精性脂肪性肝病（NAFLD）是一个描述肝细胞脂肪过度积累的术语，并与代谢综合征和胰岛素抵抗有关。NAFLD的患病率正在增加，并且与代谢综合征及其组成部分的患病率增加并行。这就是为什么制定了克罗地亚准则，涵盖了NAFLD危险因素患者的筛查方案，以及推荐的NAFLD患者的诊断性检查和治疗。2型糖尿病患者应进行NAFLD筛查，或具有两个或更多危险因素的人作为代谢筛查的一部分，并通过用于检测纤维化的非侵入性实验室和成像方法进行。患者检查应排除其他肝损伤原因的存在，并确定纤维化阶段是疾病预后的最重要因素。纤维化初始阶段的患者继续在初级医疗保健水平进行监测，并管理代谢风险因素，饮食措施，增加体力活动。晚期纤维化患者应转诊至胃肠病学家/肝病学家进行进一步治疗，监测,以及并发症的检测和管理。
