Riziko kardiovaskulárních onemocnění u pacientů s nealkoholickým ztučněním jater
Pojem nealkoholické ztučnění jater (nonalcoholic fatty liver disease – NAFLD) zahrnuje široké spektrum patologických stavů od prosté steató‐ zy po nealkoholickou steatohepatitidu a cirhózu. Výskyt této choroby dosáhl epidemických rozměrů, přičemž jde o nejčastější příčinu chronického postižení jater v západních zemích.1‐4
Nealkoholickou steatózou jater trpí přibližně 20–30 % dospělých z celkové populace západních zemí a u obézních osob a diabetiků stoupá prevalence onemocnění na 70–90 %; tito nemocní jsou rovněž ve zvýšené míře ohroženi rozvojem pokročilé fibrózy a cirhózy.1‐4
Rozpoznání významu nealkoholického ztučnění jater a jeho silná vazba na metabolický syndrom1‐4 se staly motivací ke zkoumání předpokládané role této nemoci v rozvoji a progresi kardiovaskulárních chorob.5
Přibývá důkazů o tom, že kardiovaskulární onemocnění ovlivňují výsledný stav (či výsledné ukazatele) u pacientů s NAFLD častěji a výrazněji než progrese jaterního posti‐ žení.2,4,5
V tomto přehledu se soustředíme na množící se klinické důkazy potvrzující silnou spojitost mezi nealkoholickým ztučněním jater a rizikem kardiovaskulárních chorob. Vzhledem k vazbě mezi uvedenými poruchami bude zapotřebí tyto pacienty pečlivěji sledovat.
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