脂肪肝的西医药治疗Westernmedicinetreatmentonfattyliver.PDF

脂肪肝的西醫藥治療 Western medicine treatment on fatty liver Vincent Wong                                  黃煒燊 Institute of Digestive Disease       消化疾病研究所 Disclosures • Advisory board member: AbbVie, Gilead, Janssen, Otsuka, Roche • Consultancy: Merck, Novomedica • Speaker: Abbott, AbbVie, Echosens, Gilead, Novartis Fatty liver Less common causes: Drugs (e.g. methotrexate, steroids) Rapid weight loss Acute fatty liver of pregnancy Non-alcoholic fatty liver disease (NAFLD) The spectrum of disease Non‐alcoholic  Non‐alcoholic  Progressive  fatty liver steatohepatitis Cirrhosis liver fibrosis (NAFL) (NASH) Courtesy of Dr Anthony Chan, PWH Jilin, n=6043 NAFLD 16%, ALD 4% Shanghai, n=3175 NAFLD 15%, ALD 1% Chengdu, n=9094 NAFLD 6%, ALD 3% Guangzhou, n=3543 NAFLD 15%, ALD 2% Hong Kong, n=1013 NAFLD 27%, ALD 0.4% Fan JG. J Gastroenterol Hepatol 2013;28(Suppl 1):11 Wong VW et al. Gut 2012;61:409 The HK-MRS Study Advanced fibrosis or  cirrhosis by Fibroscan: 4% N=922 Fatty liver by 1H‐MRS: 28% No or minimal fibro