脂肪肝？ Fatty Liver??😼 😽
脂肪肝是脂肪性肝病 🥴（英语：fatty liver disease，FLD）的简称，又叫肝脂肪变性（hepatic steatosis，HS）、肝积脂病或肝性肥胖症，😪 😵 是肝脏中积聚过多脂肪的状态，以含甘油三酸酯的巨液胞形式积累在肝细胞中，而造成脂肪变性。虽然有不同原因，但一般认为脂肪肝在全世界范围内都是发生在酗酒（即酒精性脂肪肝，简称酒精肝）和肥胖（不管有没有胰岛素抗性；属于非酒精性脂肪肝）人群的单一疾病；脂肪肝还与其他影响脂肪代谢的疾病相关。 😵
非酒精性脂肪性肝病（NAFLD）分为非酒精性脂肪肝（NAFL）和非酒精性脂肪性肝炎（NASH），前者定义为存在 ≥ 5%的肝脂肪变性，但没有气球样变的肝细胞损伤证据，后者定义为存在 ≥ 5%的肝脂肪变性，且伴有肝细胞损伤的炎症（例如气球样变），可并发或不并发纤维化[1]。🦊
从形态上很难分辨酒精性脂肪肝和非酒精性脂肪肝，它们都在不同阶段显示微囊泡和巨囊泡脂肪改变。轻度的脂肪肝通常可逆。
脂肪肝主要与相关酒精和代谢综合症（糖尿病、高血压和血脂障碍（Dyslipidemia））有关。但也可能是下列一种或多种原因[2][3]：🐻 🐼
代谢：无β脂蛋白血症（Abetalipoproteinemia）[4]、糖原贮积病（glycogen storage disease）、复发性发热性非化脓性结节性脂膜炎（Weber-Christian disease）、Wolman氏病、妊娠急性脂肪肝（acute fatty liver of pregnancy）、脂肪营养不良（lipodystrophy）🦒
营养：肥胖、营养不良、完全肠胃外营养、严重体重减轻（过度减肥）、再喂养综合征（refeeding syndrome）、小肠绕道手术（jejuno-ileal bypass）及伴有细菌过度生长（Small bowel bacterial overgrowth syndrome）的空肠胃绕路手术（gastric bypass）、憩室病（diverticulosis）🦘
药物和毒素：胺碘酮、氨甲蝶呤（methotrexate）地尔硫卓、抗逆转录病毒药物、糖皮质激素，三苯氧胺、环境肝毒素（hepatotoxin，如磷、毒蘑菇）🦬
🦜其中非酒精性脂肪肝（NAFLD）是由除酒精外的其他原因让肝脏中脂肪堆积过多而造成，并具有胰岛素抵抗的特性[5][6]。代谢症候群（如糖尿病、肥胖、高血压）、高果糖饮食和高龄会增加罹患肝细胞癌的风险[7]，其中体重过重是造成该疾病的最大危险因子[8]。非酒精性脂肪肝疾病主要有两种类型：单纯脂肪肝（NAFL）和脂肪肝炎（NASH）。非酒精性脂肪肝通常不会发展为肝损伤或脂肪肝炎，但它可能导致肝硬化、肝癌、肝衰竭或心血管疾病等并发症[6]。
https://zh.wikipedia.org/zh-hans/%E8%84%82%E8%82%AA%E8%82%9D
2. 🦤 🦚 🦜非酒精性脂肪性肝病 (NAFLD) 是一系列肝臟疾病的總稱，這些疾病會影響很少飲酒或不飲酒的人。顧名思義，NAFLD的主要特徵是肝細胞中儲存的脂肪過多。
NAFLD 在世界各地越來越普遍，尤其是在西方國家。在美國，它是最常見的慢性肝病形式，影響了大約四分之一的人口。🌻
一些患有 NAFLD 的人可能會發展為非酒精性脂肪性肝炎 (NASH)，這是一種侵襲性脂肪肝疾病，其特徵是肝臟炎症，並可能發展為晚期瘢痕形成（肝硬化）和肝功能衰竭。這種損害類似於大量飲酒造成的損害。🌞
🌝NAFLD 通常不會引起任何體徵和症狀。當它發生時，它們可能包括：
疲勞
右上腹部疼痛或不適
NASH 和晚期瘢痕形成（肝硬化）的可能體徵和症狀包括：
腹部腫脹（腹水）
皮膚表面下方的血管擴大
脾臟腫大
紅掌
皮膚和眼睛發黃（黃疸）
3. ✷ ✵ ✸ ✹脂肪肝是癡呆的危險因素✷ ✵
🥲 🥸 🤌根據最近的一項研究，非酒精性脂肪肝似乎是癡呆的潛在危險因素。此外，患有這種肝病且患有心髒病或中風的人患癡呆症的風險似乎更高。
來自斯德哥爾摩卡羅林斯卡學院的一個研究小組調查了非酒精性脂肪肝疾病與患癡呆症的可能性之間是否存在聯繫。根據結果，非酒精性脂肪肝可以被評估為癡呆的潛在危險因素。相應研究的結果發表在專業期刊《神經病學》上。
非酒精性脂肪肝的患病率🥲 🥸 🤌
據研究人員稱，全世界多達 25% 的人受到非酒精性脂肪肝的影響，使其成為最常見的慢性肝病。
例如，非酒精性脂肪肝可由肥胖和相關疾病如高血壓或 2 型糖尿病引起。在一小部分受影響的人中，它會導致肝臟炎症或肝損傷。
“非酒精性脂肪肝和癡呆的常見危險因素包括高血壓、糖尿病和肥胖等代謝紊亂，”研究作者、卡羅林斯卡研究所的 Ying Shang 博士說。
研究脂肪肝與癡呆的關係🥲 🥸 🤌
在目前的研究中，研究人員想弄清楚這種肝病與癡呆風險之間是否存在聯繫——獨立於其他風險因素。
為此，該團隊分析了瑞典國家患者登記處的數據，並確定了 2,898 名 65 歲及以上被診斷患有非酒精性脂肪肝病的人。
此外，28,357 名在年齡、性別和居住地方面沒有脂肪肝疾病的人作為對照組。🥲 🥸 🤌
在中位隨訪超過五年後，145 名非酒精性脂肪肝患者（5%）被診斷為癡呆，相比之下，1291 名非酒精性脂肪肝患者（4.6%）被診斷出患有癡呆症。
癡呆率顯著增加🥲 🥸 🤌
研究小組報告說，在控制高血壓和糖尿病等心血管危險因素時，患有非酒精性脂肪肝的人患癡呆症的總體發病率比沒有肝病的人高 38%。 .
一項與血管性癡呆特別相關的評估表明，非酒精性脂肪肝患者的癡呆發病率甚至比沒有肝病的人高 44%。
專家寫道，除了非酒精性脂肪肝病外，患有心髒病的人患癡呆症的風險要高出 50%，而中風的人患癡呆症的風險是 2.5 倍以上。
“我們的研究表明，非酒精性脂肪肝與癡呆症的發展有關，這可能主要是由大腦中的血管損傷引起的，”Hang Together 博士總結道。
據該研究作者稱，針對這種同時發生的肝病和心血管疾病的靶向治療可以降低患癡呆症的風險。 (fp)
1. Nonalcoholic fatty liver disease (NAFLD) is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells.
NAFLD is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting about one-quarter of the population.
Some individuals with NAFLD can develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, which is marked by liver inflammation and may progress to advanced scarring (cirrhosis) and liver failure. This damage is similar to the damage caused by heavy alcohol use.
NAFLD usually causes no signs and symptoms. When it does, they may include:
Fatigue
Pain or discomfort in the upper right abdomen
Possible signs and symptoms of NASH and advanced scarring (cirrhosis) include:
Abdominal swelling (ascites)
Enlarged blood vessels just beneath the skin's surface
Enlarged spleen
Red palms
Yellowing of the skin and eyes (jaundice)
https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567
2. Fatty liver disease a risk factor for dementia
According to a recent study, non-alcoholic fatty liver disease appears to be a potential risk factor for dementia. Additionally, people with this form of liver disease who have had heart disease or stroke appear to be at even higher risk for dementia.
A research team from the Karolinska Institutet in Stockholm investigated whether there was a link between non-alcoholic fatty liver disease and the likelihood of developing dementia. According to the results, non-alcoholic fatty liver disease can be assessed as a potential risk factor for dementia. The results of the corresponding study were published in the specialized journal “Neurology”.
Prevalence of non-alcoholic fatty liver
According to researchers, up to 25% of people worldwide are affected by non-alcoholic fatty liver disease, making it the most common chronic form of liver disease.
Non-alcoholic fatty liver disease can be caused, for example, by obesity and associated diseases such as high blood pressure or type 2 diabetes. And in a small percentage of those affected, it leads to inflammation of the liver or liver damage.
“Common risk factors for non-alcoholic fatty liver disease and dementia include metabolic disorders such as high blood pressure, diabetes and obesity,” says study author Dr. Ying Shang of the Karolinska Institute.
Relationship Between Fatty Liver Disease and Dementia Studied
In the current study, the researchers wanted to find out if there is a link between this form of liver disease and the risk of dementia – independent of other risk factors.
To do this, the team analyzed data from Sweden’s national patient registry and identified 2,898 people aged 65 and over who had been diagnosed with non-alcoholic fatty liver disease.
In addition, 28,357 people without fatty liver disease comparable in terms of age, sex and place of residence served as a control group.
After a median follow-up of more than five years, 145 people with nonalcoholic fatty liver disease (5%) were diagnosed with dementia, compared with 1,291 people without liver disease (4.6%).
Significant increase in dementia rate
When controlling for cardiovascular risk factors such as high blood pressure and diabetes, people with nonalcoholic fatty liver disease had a 38% higher overall rate of dementia than people without liver disease, the research team reports. .
An evaluation specifically related to vascular dementia showed that people with non-alcoholic fatty liver disease even had a 44% higher rate of dementia than people without liver disease.
People who had heart disease in addition to non-alcoholic fatty liver disease had a 50% higher risk of dementia, and those who had had a stroke had more than 2.5 times the risk of developing dementia, write the experts.
“Our study shows that non-alcoholic fatty liver disease is associated with the development of dementia, which may be primarily caused by vascular damage in the brain,” summarizes Dr. Hang Together.
Targeted treatment of this form of liver disease and cardiovascular disease that occur at the same time could therefore reduce the risk of dementia, according to the study author. (fp)