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2018, Número 2

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Rev Med MD 2018; 9.10 (2)


Enfermedad hepática por hígado graso no alcohólico ¿Dónde estamos y a dónde vamos?

Velarde-Ruiz VJA, Mercado-Jáuregui LA, Bocaletti-García MM, Pinzón-Flores ÓE, Barrientos-Ávalos JR

Idioma: Español
Referencias bibliográficas: 72
Paginas: 155-163
Archivo PDF: 645.12 Kb.


RESUMEN

Actualmente las enfermedades del hígado van en aumento y gran parte de estas son las asociadas a comorbilidades como el síndrome metabólico o a alguno de sus componentes. La enfermedad por hígado graso no alcohólico tiene un amplio espectro desde esteatosis, esteatohepatitis, fibrosis, cirrosis y en algunos casos el cáncer hepatocelular. Se prevé que en los próximos años una de las principales causas de cirrosis y de necesidad de trasplante de hígado será la enfermedad por hígado graso no alcohólico. En México la prevalencia reportada es variable. Es importante reconocer los factores de riesgo asociados a esta enfermedad como lo es la diabetes, obesidad, susceptibilidad genética y asociaciones emergentes (síndrome de ovario poliquístico, el hipotiroidismo, la apnea obstructiva del sueño, hipopituitarismo e hipogonadismo). La química hepática puede ser considerada una prueba inicial para investigar la enfermedad y el ultrasonido una prueba complementaria accesible. Existen métodos de evaluación no invasivos de fibrosis en estos pacientes. El impacto real de la enfermedad por hígado graso no alcohólico es la mortalidad cardiovascular asociada. Las bases del tratamiento son la dieta y el ejercicio. Los fármacos con mayor evidencia siguen siendo pioglitazona y vitamina E para ciertos escenarios clínicos. Existen nuevas terapias farmacológicas y quirúrgicas emergentes que requieren más valoración.


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