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Abstract：
Metabolic-associated fatty-liver disease (MAFLD), previously known as non-alcoholic fatty liver disease, is the most widespread and emerging chronic liver disease worldwide, with increasing prevalence rates also in the Asia-Pacific region. The disease has a high socio-economic burden as it negatively impacts the finances and quality of life of individuals affected and has a major burden on healthcare systems. The most important pathological event in MAFLD aetiopathogenesis is oxidative stress, which leads to functional and structural abnormalities in the liver as well as being involved in the development of other concomitant cardiometabolic diseases. MAFLD is a rather complex multisystemic clinical condition involving liver damage and a wide spectrum of extrahepatic manifestations such as obesity, type 2 diabetes, metabolic syndrome and cardiovascular diseases. This complexity requires the cooperation of multiple experts to identify MAFLD at an early stage, treat associated comorbidities, and promptly refer the patient to the hepatologist when needed. This review summarizes the current knowledge about MAFLD and reports the opinion of a group of experts on the increasing prevalence and burden of the disease in the southeast Asia region, the current journey of patients with MAFLD in developing countries, the role of oxidative stress and antioxidant treatment, and the importance of a multidisciplinary approach for early diagnosis and disease management. This article is part of the Current clinical use of silymarin in the treatment of toxic liver diseases: a case series Special Issue: https://www.drugsincontext.com/special_issues/current-clinical-use-of-silymarin-in-the-treatment-of-toxic-liver-diseases-a-case-series.
摘要：
代谢相关脂肪性肝病（MAFLD），以前被称为非酒精性脂肪性肝病，是全球范围内最普遍和新兴的慢性肝病，亚太地区的患病率也在上升。该疾病具有很高的社会经济负担，因为它对受影响个人的财务和生活质量产生负面影响，并对医疗保健系统造成重大负担。MAFLD发病机制中最重要的病理事件是氧化应激，导致肝脏功能和结构异常，并参与其他伴随的心脏代谢疾病的发展。MAFLD是一种相当复杂的多系统临床疾病，涉及肝损害和广泛的肝外表现，如肥胖，2型糖尿病,代谢综合征和心血管疾病。这种复杂性需要多个专家的合作，以便在早期阶段识别MAFLD，治疗相关的合并症，并在需要时迅速将患者转介给肝病专家。这篇综述总结了当前有关MAFLD的知识，并报告了一组专家对该疾病在东南亚地区的患病率和负担不断增加的看法。发展中国家MAFLD患者的当前旅程，氧化应激和抗氧化治疗的作用，以及多学科方法对早期诊断和疾病管理的重要性。本文是当前临床使用水飞蓟素治疗中毒性肝病的一部分：病例系列特刊：https：//www。drugsincontext.com/special_issues/current-clinical-use-of-silymarin-in-the-the-the-treatment-of-毒性-肝病-a-case-series.
