Jatern� manifestace metabolick�ho syndromu se nyn� jmenuje MASLD - aktu�ln� pohled na nej�ast�j�� onemocn�n� jater sou�asnosti (original) (raw)

Vnitr Lek 2024, 70(1):E8-E14 | DOI: 10.36290/vnl.2024.013

1IV. intern� klinika - klinika gastroenterologie a hepatologie, V�eobecn� fakultn� nemocnice v Praze a 1. l�ka�sk� fakulta, Univerzita Karlova, Praha

2Odd�len� gastroenterologie a hepatologie, Krajsk� nemocnice Liberec, a. s.

Nealkoholov� tukov� choroba jater (NAFLD) p�edstavuje spolu s alkoholovou chorobou jater nej�ast�j�� chronick� onemocn�n� jater �esk� populace. Ob� jednotky mohou nab�vat v z�vislosti na pokro�ilosti onemocn�n� cel� spektrum klinick�ch obraz� od prost� steat�zy a� po cirh�zu jater s jej�mi z�va�n�mi komplikacemi - zejm�na port�ln� hypertenz� a hepatocelul�rn�m karcinomem. S rostouc� prevalenc� diabetu mellitu 2. typu a obezity vzr�st� v�znam zejm�na prvn� v��e jmenovan� choroby, o jej�� diagnostice a l��b� pojedn�v� tento �l�nek. Sou�asn� si auto�i dovoluj� �ten��e upozornit na komplexn� zm�nu nomenklatury jatern�ch onemocn�n�, kter� klade mnohem v�t�� d�raz na kardiometabolick� rizika s nimi spojen�. Sou�asn� bylo reflektov�no p��n� pacient� ve vztahu k vynech�n� stigmatizuj�c�ch pojm� "(ne)alkoholov�" a "tukov�" v n�zvu onemocn�n�. Jako zast�e�uj�c� term�n byl zvolen n�zev steatotick� jatern� onemocn�n� (SLD; steatotic liver disease), kter� zahrnuje r�zn� etiologie steat�zy. P�vodn� NAFLD se nyn� naz�v� MASLD (z angl. Metabolic Dysfunction-Associated Steatotic Liver Disease), tedy jatern� steat�za asociovan� s metabolickou dysfunkc�. MASLD zahrnuje pacienty, kte�� maj� steat�zu jater, jeden z p�ti kardiometabolick�ch rizikov�ch faktor� a prakticky nepij� alkohol. Term�n steatohepatitida je st�le pova�ov�n za d�le�it� patofyziologick� koncept a byl proto zachov�n. Preferovan� n�zev je nyn� MASH - steatohepatitida asociovan� s metabolickou dysfunkc� (z angl. Metabolic-Associated SteatoHepatitis).

Kl��ov� slova: jatern� cirh�za, jatern� fibr�za, jatern� steat�za, MASLD, metabolick� syndrom, steatohepatitida.

The liver manifestation of metabolic syndrome is now called MASLD - an up-to-date view of the most common liver disease today

Non-alcoholic fatty liver disease together with alcohol-related liver disease represent the most common chronic liver diseases in the Czech population. Both could - according to their severity - manifest as a whole spectrum of clinical pictures from simple steatosis to cirrhosis with its serious complications, especially portal hypertension and hepatocellular carcinoma. Due to increasing prevalence of diabetes mellitus type 2 and obesity, the first disease mentioned above gains importance and this article is discussig its diagnosis and treatment options. At the same time, the authors take the liberty of drawing the reader's attention to a significant change in the nomenclature of liver diseases placing much greater emphasis on the associated cardiometabolic risks. At the same time, the wishes of the patients were reflected and stigmatizing terms "non-alcoholic" and "fatty" were omitted. The name steatotic liver disease (SLD), which affects various etiologies of steatosis, was chosen as an umbrella term. The original NAFLD is now called MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease), i.e. liver steatosis associated with metabolic dysfunction. MASLD includes patients who have hepatic steatosis, one of the five cardiometabolic risk factors and drink minimal amounts of alcohol. The term steatohepatitis is still considered an important pathophysiological concept and has therefore been retained. The preferred name is now MASH - Metabolic-Associated SteatoHepatitis.

Keywords: liver cirrhosis, liver fibrosis, liver steatosis, MASLD, metabolic syndrome, steatohepatitis.

P�ijato: 23. �nor 2024; Zve�ejn�no: 26. �nor 2024 Zobrazit citaci

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