비알콜성지방간의 유병율과 병리기전에 대한 문헌적 고찰

Overview for Prevalence and Pathology of Non-Alcoholic Fatty Liver Disease

  • 박연화 (대전대학교 한의과대학 간장면역학교실) ;
  • 유사라 (대전대학교 한의과대학 간장면역학교실) ;
  • 손창규 (대전대학교 한의과대학 간장면역학교실)
  • Park, Yeun-Hwa (Liver and Immunology Research Center of Dae-Jeon University Oriental Hospital) ;
  • Yoo, Sa-Ra (Liver and Immunology Research Center of Dae-Jeon University Oriental Hospital) ;
  • Son, Chang-Gue (Liver and Immunology Research Center of Dae-Jeon University Oriental Hospital)
  • 발행 : 2011.03.30

초록

Objectives : Non-alcoholic fatty liver disease (NAFLD) is known to be increasing and becoming a health-related issue worldwide. This study aimed to analyze its prevalence and characterize NAFLD. Methods : NAFLD-related papers were surveyed via PubMed and in Korean medical journals, and then the prevalence and pathology were reviewed. Results : The prevalence of NAFLD in the general population is around 10~30% worldwide. The prevalence of NAFLD in Korea is estimated as 15~30%, which is higher than in China and Japan. The most important etiological-factors of NAFLD include central obesity resulting from excessive calorie intake and less physical activity, which lead to adiponectin hypoactivity and insulin resistance. The Oriental medicine view point of NAFLD pathology is phlegm-dampness by dysfunction of free flow in liver. Conclusions : This study provided an overview of the prevalence and pathology of NAFLD, and can support the development of a strategy for traditional Korean medicine-based prevention or treatment of NAFLD.

키워드

참고문헌

  1. Adams LA, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgrad Med J. 2006;82(967):315-22. https://doi.org/10.1136/pgmj.2005.042200
  2. Clark JM, Diehl AM. Nonalcoholic fatty liver disease: an under-recognized cause of cryptogenic cirrhosis. JAMA, 2003;289(22):3000-4. https://doi.org/10.1001/jama.289.22.3000
  3. Chavez-Tapia NN, Uribe M, Ponciano-Rodriguez G, Medina-Santillan R, Mendez-Sanchez N. New insights into the pathophysiology of nonalcoholic fatty liver disease. Ann Hepatol. 2009;8:S9-S17.
  4. Abrams GA, Kunde SS, Lazenby AJ, Clements RH. Portal fibrosis and hepatic steatosis in morbidly obese subjects: a spectrum of nonalcoholic fatty liver disease. Hepatology. 2004;40:475-83. https://doi.org/10.1002/hep.20323
  5. Neuschwander-Tetri BA. Lifestyle modification as the primary treatment of NASH. Clin Liver Dis. 2009;13(4):649-65. https://doi.org/10.1016/j.cld.2009.07.006
  6. Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011;140(1):124-31. https://doi.org/10.1053/j.gastro.2010.09.038
  7. Larter CZ, Chitturi S, Heydet D, Farrell GC. A fresh look at NASH pathogenesis. Part 1: the metabolic movers. J Gastroenterol Hepatol. 2010;25(4):672-90. https://doi.org/10.1111/j.1440-1746.2010.06253.x
  8. Golovanova EV, Vinnitskaia EV, Shaposhnikova NA, Petrakov AV, Mel'kina ES. Effectiveness of the new plant hepatoprotector-Ropren in patients with non-alcoholic steatohepatitis. Eksp Klin Gastroenterol. 2010;(7):97-102.
  9. Hong XZ, Li LD, Wu LM. Effects of fenofibrate and xuezhikang on high-fat diet-induced nonalcoholic fatty liver disease. Clin Exp Pharmacol Physiol. 2007;34(1-2):27-35. https://doi.org/10.1111/j.1440-1681.2007.04547.x
  10. Han CW, Lee JH. Effects of KHchunggan-tang on the Nonalcoholic Fatty Liver Disease in Palmitate-induced Cellular Model. J Korean Oriental Med. 2011;32(1):109-20.
  11. Omagari K, Kadokawa Y, Masuda J, Egawa I, Sawa T, Hazama H, et al. Fatty liver in nonalcoholic non-overweight Japanese adults: incidence and clinical characteristics. J Gastroenterol Hepatol. 2002;17(10):1098-105. https://doi.org/10.1046/j.1440-1746.2002.02846.x
  12. Tsuruta G, Tanaka N, Hongo M, Komatsu M, Horiuchi A, Hamamoto K, et al. Nonalcoholic fatty liver disease in Japanese junior high school students: its prevalence and relationship to lifestyle habits. J Gastroenterol. 2010;45(6):666-72. https://doi.org/10.1007/s00535-009-0198-4
  13. Alavian SM, Mohammad-Alizadeh AH, Esna- Ashari F, Ardalan G, Hajarizadeh B. Non alcoholic fatty liver disease prevalence among school-aged children and adolescents in Iran and its association with biochemical and anthropometric measures. Liver Int. 2009;29(2):159-63. https://doi.org/10.1111/j.1478-3231.2008.01790.x
  14. Fan JG, Zhu J, Li XJ, Chen L, Li L, Dai F, et al. Prevalence of and risk factors for fatty liver in a general population of Shanghai, China. J Hepatol. 2005;43(3):508-14. https://doi.org/10.1016/j.jhep.2005.02.042
  15. Zhou YJ, Li YY, Nie YQ, Ma JX, Lu LG, Shi SL, et al. Prevalence of fatty liver disease and its risk factors in the population of South China. World J Gastroenterol. 2007;13(47):6419-24. https://doi.org/10.3748/wjg.13.6419
  16. Chen CH, Huang MH, Yang JC, Nien CK, Yang CC, Yeh YH, et al. Prevalence and risk factors of nonalcoholic fatty liver disease in an adult population of taiwan: metabolic significance of nonalcoholic fatty liver disease in nonobese adults. J Clin Gastroenterol. 2006;40(8):745-52. https://doi.org/10.1097/00004836-200609000-00016
  17. Amarapurkar D, Kamani P, Patel N, Gupte P, Kumar P, Agal S, et al. Prevalence of nonalcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6(3):161-3.
  18. Das K, Mukherjee PS, Ghosh A, Ghosh S, Mridha AR, et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology. 2010;51(5):1593-602. https://doi.org/10.1002/hep.23567
  19. Dassanayake AS, Kasturiratne A, Rajindrajith S, Kalubowila U, Chakrawarthi S, De Silva AP, et al. Prevalence and risk factors for nonalcoholic fatty liver disease among adults in an urban Sri Lankan population. J Gastroenterol Hepatol. 2009;24(7):1284-8. https://doi.org/10.1111/j.1440-1746.2009.05831.x
  20. Zelber-Sagi S, Nitzan-Kaluski D, Halpern Z, Oren R. Prevalence of primary non-alcoholic fatty liver disease in a population-based study and its association with biochemical and anthropometric measures. Liver Int. 2006;26(7):856-63. https://doi.org/10.1111/j.1478-3231.2006.01311.x
  21. Caballeria L, Pera G, Auladell MA, Toran P, Munoz L, Miranda D, et al. Prevalence and factors associated with the presence of nonalcoholic fatty liver disease in an adult population in Spain. Eur J Gastroenterol Hepatol. 2010;22(1):24-32. https://doi.org/10.1097/MEG.0b013e32832fcdf0
  22. Seo SH, Lee HW, Park HW, Jang BG, Chung WJ, Park KS, et al. Prevalence and associated factors of nonalcoholic fatty Liver disease in the health screen examinees. Korean Association of Int. Med. 2006;70(1):26-32.
  23. Na HY, Baek DJ, Lee SH, Choi YE, Cho KH, Pak SB, et al. Predictors Related to the Non-alcoholic Fatty Liver Disease. Korean J Fam Med. 2010;31(02): 94-100. https://doi.org/10.4082/kjfm.2010.31.2.94
  24. Park SH, Jeon WK, Kim SH, Kim HJ, Park DI, Cho YK, et al. Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol. 2006;21(1 Pt 1):138-43. https://doi.org/10.1111/j.1440-1746.2005.04086.x
  25. Jun EJ, Kim HS, Chung HK, Lee JH, Kim SR, Jung ED. Free T4 is Negatively Correlated with Non-alcoholic Fatty Liver Disease in Euthyroid Women. Edocrinology and Metabolism. 2009;24(2):87-92.
  26. Kim SY, Lee HS, Lee SH, Oh YA, Kim HL, Sim KW. The Association of Nonalcoholic Fatty Liver Disease with Metabolic Syndrome. Korean J Fam Med. 2007;28(9):667-74.
  27. Park JS, Jung HC, Kim DY, Baek SD, Kim NI, Lee JU, et al. Risk factors of nonalcoholic fatty liver in healthy medical check up. The Dongguk Journal of Medicine. 2004;11(1):379-82.
  28. Park SH, Kim BI, Yoo TW, Kim JW, Cho YK, Sung IK, et al. Nonalcoholic Fatty Liver Disease and Abnormal Liver Function Test in the Health Screen Examinees: the Relationship with Insulin Resistance. Korean J Gastroenterol. 2003;41(5):366-73.
  29. Kim HK, Suh CJ, Yoon HJ, Hwang YH, Lee KY, Park HY, et al. Association between Non-alcoholic Fatty Liver and Metabolic Diseases. Edocrinology and Metabolism. 2002;17(4):526-33.
  30. Ahn JE, Ham JO, Hwang KY, Kim JJ, Lee BK, Nam TS, et al. A cross-sectional al study on prevalence rate and contributing factors of fatty liver diagnosed by ultrasonography. J. of Preventive Medicine and Public Health. 1991;24(2):195-210.
  31. Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011;140(1):124-31. https://doi.org/10.1053/j.gastro.2010.09.038
  32. Perez M, Gonzales L, Olarte R, Rodriguez NI, Tabares M, Salazar JP, et al. Nonalcoholic fatty liver disease is associated with insulin resistance in a young Hispanic population. Prev Med. 2011;52(2):174-7. https://doi.org/10.1016/j.ypmed.2010.11.021
  33. Vanni E, Bugianesi E, Kotronen A, De Minicis S, Yki-Jarvinen H, Svegliati-Baroni G. From the metabolic syndrome to NAFLD or vice versa? Dig Liver Dis. 2010;42(5):320-30. https://doi.org/10.1016/j.dld.2010.01.016
  34. Uchil D, Pipalia D, Chawla M, Patel R, Maniar S, Narayani, et al. Non-alcoholic fatty liver disease (NAFLD)--the hepatic component of metabolic syndrome. J Assoc Physicians India. 2009;57:201-4.
  35. Polyzos SA, Kountouras J, Zavos C, Tsiaousi E. The role of adiponectin in the pathogenesis and treatment of non-alcoholic fatty liver disease. Diabetes Obes Metab. 2010;12(5):365-83. https://doi.org/10.1111/j.1463-1326.2009.01176.x
  36. Lockman KA, Nyirenda MJ. Interrelationships between hepatic fat and insulin resistance in non-alcoholic fatty liver disease. Curr Diabetes Rev. 2010;6(5):341-7. https://doi.org/10.2174/157339910793360879
  37. Liu Q, Bengmark S, Qu S. The role of hepatic fat accumulation in pathogenesis of non-alcoholic fatty liver disease (NAFLD). Lipids Health Dis. 2010;9:42. https://doi.org/10.1186/1476-511X-9-42
  38. Videla LA, Rodrigo R, Araya J, Poniachik J. Insulin resistance and oxidative stress interdependency in non-alcoholic fatty liver disease. Trends Mol Med. 2006;12(12):555-8. https://doi.org/10.1016/j.molmed.2006.10.001
  39. Kim SH, Lee JH, Jung YJ, Choi MY, Kim YC, Woo HJ. A Case of Nonalcoholic Steatohepatitis in a child patient. Korean J. Orient. Int. 2010;31(2):1106-10.
  40. Yoo JY, Lee JH. Effect of Saengangtanggami-bang on nonalcoholic fatty liver disease model induced by fatty liver. Korean J. Orient. Int. 2007;Spring(1):143-57.