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Fatty Liver Disease : Nash and Related Disorders - part 2

bệnh nhân phẫu thuật béo phì người lớn sống gan các nhà tài trợ Marcos et al. [86] phẫu thuật giảm béo Marceau et al. [87] Del Gaudio et al. [88] Luyek et al. [89] Dixon et al. [48] Klain et al. [90] Silverman et al. [91] chung siêu âm kiểm tra dân số Nomura et al. | EPIDEMIOLOGY AND RISK FACTORS OF NASH Table 3.1 Prevalence of NAFLD and NASH. Study population Prevalence selected study populations Liver biopsy Nonomara et al. 82 1.2 Propst etal. 81 15 4.8 Hultcrantz et al. 27 54 Skelly et al. 66 66 34 Daniel et al. 67 84 Mathieson et al. 64 42 Ratziu et al. 83 79 49 CT scan El-Hassan et al. 11 10 Postmortem analysis Random deaths Hilden et al. 84 24 Ground 85 16 2.1 Hospitalized deaths Wanless Lenz 23 Lean 3 Obese 19 Surgical patients Adult living liver donors Marcos et al. 86 20 Bariatric surgery Marceau et al. 87 86 14 Del Gaudio et al. 88 78 21 Luyek et al. 89 74 Dixon et al. 48 71 25 Klain etal. 90 56 29 Silverman et al. 91 78 21 general population screening Ultrasound Nomura et al. 10 23 Lonardo et al. 94 22 Bellentani et al. 28 Lean 16 Obese 76 Liver enzyme screening Patt et al. 72 14-21 NHANES III 3-23 Clark et al. 69 23 Clark et al. 71 23 Ruhl Everhart 70 3 Lean 1 Obese 6 Numbers in square brackets indicate the reference number for the specific study cited. Numbers in parentheses indicate the percentage of patients with hepatic histology consistent with NASH in studies that differentiated NASH from less severe forms of NAFLD. 30-40 of these patients may succumb to liver-related death over a 10-year period 22 the mortality rate being similar to 31 or worse than 32 cirrhosis associated with hepatitis C. NASH is also now considered the major cause of cryptogenic cirrhosis 33 . NASH-associated cirrhosis can also decompensate into subacute liver failure 34 progress to hepatocellular carcinoma HCC 35-39 and re-occur posttransplantation 40 41 . In contrast steatosis alone is reported to have a more benign clinical course 22 26 although progression of fibrosis to cirrhosis has occurred in 3 of patients with steatosis alone in the author s series 22 . Definition of non-alcoholic By definition excessive alcohol consumption excludes the diagnosis of NAFLD. However the definition of excessive has been elusive and a wide range of .