[{"Title":"Довідкові матеріали","UniqueID":"v102713107_uk","Index":1.0,"Summary":"

1. Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Ann Hepatol. 2024;29(1):101133. doi:10.1016/j.aohep.2023.101133

","HeadType":"G_Head","SchemeItemProp":"","Children":[]},{"Title":"Патофізіологія","UniqueID":"v12304862_uk","Index":2.0,"Summary":"

Steatotic liver disease develops for many reasons, involves many different biochemical mechanisms, and causes different types of liver damage. Pathophysiology involves fat accumulation (steatosis), inflammation, and, variably, fibrosis. Steatosis results from hepatic triglyceride accumulation. Possible mechanisms for MASLD and MASH are complex; however, insulin resistance is a key factor in pathogenesis, leading to increased release of free fatty acids in the liver and hepatic de novo lipogenesis. Other potential mechanisms include reduced synthesis of very low density lipoprotein (VLDL), increased hepatic triglyceride synthesis, genetic factors with lipid handling, and possibly alterations in hepatic uric acid production ( 1 ). Ongoing inflammation can stimulate hepatic stellate cells, resulting in fibrosis . If advanced, MASH can cause cirrhosis (sometimes with progression to hepatocellular carcinoma ) and portal hypertension . MASH can also regress to simple steatosis ( 2, 3 ).

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"Довідкові матеріали щодо патофізіології","UniqueID":"v102713125_uk","Index":1.0,"Summary":"

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"Симптоми та ознаки","UniqueID":"v12304865_uk","Index":3.0,"Summary":"

Most patients are asymptomatic, especially those with simple steatosis. However, some have fatigue, malaise, or right upper quadrant abdominal discomfort. Hepatomegaly develops in approximately 75% of patients with MASH ( 1 ). Splenomegaly may develop if advanced hepatic fibrosis is present and is usually the first indication that portal hypertension has developed. Patients with cirrhosis due to MASH can be asymptomatic and may lack the usual signs of chronic liver disease.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"signOrSymptom\" itemscope itemtype=\"http://schema.org/MedicalSignOrSymptom\"","Children":[{"Title":"Довідковий матеріал щодо симптомів та ознак","UniqueID":"v102713138_uk","Index":1.0,"Summary":"

","HeadType":"G_Head","SchemeItemProp":"itemprop=\"signOrSymptom\" itemscope itemtype=\"http://schema.org/MedicalSignOrSymptom\"","Children":[]}]},{"Title":"Діагностика","UniqueID":"v12304868_uk","Index":4.0,"Summary":"

Hepatic steatosis (by imaging, biomarkers, or biopsy)

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"Довідкові матеріали щодо діагностики","UniqueID":"v45110733_uk","Index":1.0,"Summary":"

Hepatic steatosis (by imaging, biomarkers, or biopsy)

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"Додаткова інформація","UniqueID":"v102713179_uk","Index":5.0,"Summary":"

The following English-language resource may be useful. Please note that The Manual is not responsible for the content of this resource.

","HeadType":"F_Head","SchemeItemProp":"","Children":[]},{"Title":"Лікування","UniqueID":"v12304883_uk","Index":6.0,"Summary":"

Elimination of causes and control of risk factors

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"possibleTreatment\" itemscope itemtype=\"http://schema.org/MedicalTherapy\"","Children":[{"Title":"Довідкові матеріали щодо лікування","UniqueID":"v102713194_uk","Index":1.0,"Summary":"

Elimination of causes and control of risk factors

","HeadType":"G_Head","SchemeItemProp":"itemprop=\"possibleTreatment\" itemscope itemtype=\"http://schema.org/MedicalTherapy\"","Children":[]}]},{"Title":"Прогноз","UniqueID":"v12304880_uk","Index":7.0,"Summary":"

Prognosis is driven by degree of fibrosis , the only measure that correlates with liver-related mortality and need for liver transplantation ( 1, 2 ). Simple steatosis progresses to MASH in 12 to 40% of patients ( 3 ). Prognosis is hard to predict, although patients with MASLD who have MASH on histologic examination with evidence of fibrosis have a higher burden of morbidity and mortality ( 4 ). It has been estimated that 10% of patients with MASLD progress to cirrhosis over a 20-year period ( 5 ). Alcohol as well as some medications (eg, cytotoxic medications) and metabolic disorders (eg, insulin resistance, hypertension, obesity) are associated with acceleration of metabolic dysfunction–associated steatohepatitis (MASH). As a result, even modest alcohol use should be avoided given the risk of accelerated progression to fibrosis. Prognosis is often good unless complications (eg, variceal hemorrhage ) develop.

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"Довідкові матеріали щодо прогнозу","UniqueID":"v45110753_uk","Index":1.0,"Summary":"

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"Ключові моменти","UniqueID":"v12304891_uk","Index":8.0,"Summary":"

Metabolic dysfunction–associated liver disease (MASLD) includes a benign condition called steatotic liver disease as well as metabolic dysfunction-associated steatohepatitis (MASH).

","HeadType":"F_Head","SchemeItemProp":"","Children":[]}]