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Metabolic syndrome, non-alcoholic fatty liver disease and hepatocarcinoma

2020; Arán Ediciones; Volume: 112; Linguagem: Inglês

10.17235/reed.2020.6640/2019

2340-4167

Mario Serradilla Martín, José Ramón Oliver Guillén, Ana Palomares Cano, José Manuel Ramia,

Alcohol Consumption and Health Effects

espanolEl sindrome metabolico es un conjunto de alteraciones constituido por obesidad de distribucion central, disminucion de las concentraciones del colesterol unido a lipoproteinas de alta densidad, elevacion de las concentraciones de trigliceridos, hipertension arterial e hiperglucemia. Este sindrome se ha convertido en una de las epidemias del siglo XXI. Entre sus agentes causales se encuentran la resistencia a la insulina, la leptina y adiponectina, los cambios en la microbiota y la epigenetica. Se estima una incidencia alrededor del 25% en la poblacion europea. La enfermedad hepatica grasa no alcoholica es la manifestacion hepatica del sindrome metabolico. Su prevalencia es paralela a la de la obesidad, aumentando de forma exponencial en las ultimas decadas. Recientemente, diversas publicaciones han relacionado los factores de riesgo metabolicos con la aparicion y el desarrollo de hepatocarcinoma. En este contexto, es primordial determinar si los pacientes con enfermedad hepatica grasa no alcoholica deben de seguir un protocolo de cribado de hepatocarcinoma. Hasta la fecha, la incidencia mundial publicada de hepatocarcinoma en pacientes con enfermedad hepatica grasa no alcoholica sin cirrosis es del 2,7% a los diez anos. Aunque el screening de hepatocarcinoma en pacientes con enfermedad hepatica grasa no alcoholica y cirrosis es obligatorio, la baja incidencia de hepatocarcinoma en pacientes sin cirrosis no justifica la vigilancia sistematica de esta poblacion de pacientes. Los esfuerzos se basan en determinar los subgrupos de pacientes con enfermedad hepatica grasa no alcoholica con mayor riesgo de desarrollar hepatocarcinoma EnglishThe term “metabolic syndrome” refers to a group of alterations comprising central obesity reduced high-density lipoprotein cholesterol concentrations, elevated triglyceride concentrations, arterial hypertension, and hyperglycemia. This syndrome has established itself as one of the epidemics of the 21st century. Among its causative agents are insulin resistance, leptin and adiponectin, changes in microbiota, and epigenetics. Its incidence in the European population is estimated to be around 25%. Non-alcoholic fatty liver disease is the hepatic manifestation of metabolic syndrome; its prevalence parallels that of obesity, and it has increased exponentially in recent decades. Recently, several publications have linked metabolic risk factors with the onset and development of hepatocarcinoma, and so it is essential to determine whether patients with non-alcoholic fatty liver disease should follow a protocol for hepatocarcinoma screening. At present, the worldwide incidence of hepatocarcinoma in patients with non-alcoholic fatty liver disease without cirrhosis is only 2.7%. Screening for hepatocarcinoma in patients with non-alcoholic fatty liver disease and cirrhosis is mandatory, but the low incidence of hepatocarcinoma in patients without cirrhosis does not justify the systematic monitoring of this patient population. Current efforts are based on identifying subgroups of patients with non-alcoholic fatty liver disease and a higher-than-average risk of developing hepatocarcinoma