[en] Diseases related to fatty liver, independently of alcohol consumption («non-alcoholic fatty liver disease» or NAFLD), are increasing because of the epidemics of obesity and type 2 diabetes. These disorders reflect a continuum that comprises isolated steatosis, steatohepatitis (NASH) and fibrosis, with, at the end, an increased risk of cirrhosis and hepatocarcinoma. It has been recently proposed to replace the term NAFLD by MAFLD, i.e. «Metabolic (dysfunction) Associated Fatty Liver Disease», which better reflects the pathogenesis of the disease. Inflammation plays a crucial role in the aggravation of the disorder and profoundly influences the prognostic evolution. This article illustrates the natural history of this underestimated metabolic disorder, recall the diagnostic criteria used in clinical practice, emphasizes the deleterious role of inflammation and discusses some therapeutic perspectives. [fr] Les maladies liées à un «foie gras», indépendamment de la consommation d’alcool («non-alcoholic fatty liver disease» ou NAFLD), sont en augmentation en raison de l’«épidémie» d’obésité et de diabète de type 2. Il s’agit d’un continuum comprenant la stéatose isolée, la stéatohépatite (NASH) et la fibrose avec, in fine, un risque accru de cirrhose et d’hépatocarcinome. Il a été proposé récemment de remplacer le terme NAFLD par MAFLD pour «Metabolic (dysfunction) Associated Fatty Liver Disease», ce qui reflète mieux la pathogénie de la maladie. L’inflammation joue un rôle clé dans l’aggravation du trouble et conditionne l’évolution pronostique. Cet article retrace l’histoire naturelle de cette pathologie métabolique sous-estimée, rappelle les critères diagnostiques utilisés en clinique, précise le rôle délétère de l’inflammation et conclut par quelques perspectives thérapeutiques.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
SCHEEN, André ; Centre Hospitalier Universitaire de Liège - CHU > > Service de diabétologie, nutrition, maladies métaboliques
LUYCKX, Françoise ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chimie clinique
Esser, Nathalie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de diabétologie, nutrition, maladies métaboliques
LAMPROYE, Anne ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
DELWAIDE, Jean ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
PAQUOT, Nicolas ; Centre Hospitalier Universitaire de Liège - CHU > > Service de diabétologie, nutrition, maladies métaboliques
Language :
French
Title :
Stéatohépatite non alcoolique (NASH) : un modèle d’inflammation métabolique («métaflammation»).
Alternative titles :
[en] Non-alcoholic steatohepatitis (NASH) : a model of metabolic inflammation («metaflammation»).
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