Vol 21. N°2. 2020  |  Abril-Junio de 2020


REVISIÓN - DIABETES


SÍNDROME METABÓLICO, HÍGADO GRASO NO ALCOHÓLICO Y HEPATOCARCINOMA

Autores: CARLOS BUSO, OMAR GALDAME, JULIANA FIGUEROA, LORENA LEIVA SERSING, MARIANA OJEDA, VERÓNICA PESCE, MARTÍN MARASCHIO, DANA SOBOL, DANIELA MALTAGLIATTI, ANALÍA ADAD, CINTHIA CELA, MARÍA EUGENIA CROXATTO, ALICIA SARMIENTO, ANDREA MIRANDA, SILVIA POZNIAK, CARLOS MARKMANN, CLAUDIA FOLINO


RESUMEN

En las últimas décadas, los cambios en el estilo de vida provocaron un incremento en la prevalencia del síndrome metabólico y que la enfermedad por hígado graso no alcohólico (nonalcoholic fatty liver disease, NAFLD sus siglas en inglés) se convierta en la enfermedad hepática crónica más frecuente en todo el mundo. Los componentes del síndrome metabólico no son sólo altamente prevalentes en pacientes con hígado graso no alcohólico, sino que a la vez aumentan el riesgo de desarrollarlo. Esta relación bidireccional ha sido claramente establecida. Asimismo se considera que NAFLD podría ser el componente hepático del síndrome metabólico. Aunque NAFLD se considera principalmente una enfermedad benigna, puede progresar a fibrosis hepática grave y carcinoma hepatocelular (CHC), incluso se encontraría este último en hígados no cirróticos. El objetivo de esta revisión es determinar los procesos fisiopatológicos comunes a estas entidades, cuáles son las estrategias diagnósticas recomendadas y cuáles las intervenciones terapéuticas actualmente aprobadas.

Palabras clave: cirrosis; diabetes mellitus; carcinoma hepatocelular; hígado graso no alcohólico; esteatohepatitis no alcohólica; síndrome metabólico.

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METABOLIC SYNDROME, NONALCOHOLIC FATTY LIVER DISEASE AND HEPATOCELLULAR CARCINOMA

SUMMARY

In recent decades, lifestyle changes have led to an increase in the prevalence of metabolic syndrome as nonalcoholic fatty liver disease (NAFLD) becomes the most common chronic liver disease around the world. The components of the metabolic syndrome are not only highly prevalent in patients with nonalcoholic fatty liver, but, at the same time, increase the risk of developing it. This two-way relationship has been clearly established. Inclusively, it is considered that NAFLD could be the hepatic component of the metabolic syndrome. Although NAFLD is primarily considered a benign disease, it can progress to severe liver fibrosis and hepatocellular carcinoma (HCC), the latter even being found in non-cirrhotic livers. The objective of this review is to determine the pathophysiological processes common to these entities, which are the recommended diagnostic strategies and which are the currently approved therapeutic interventions.

Key words: cirrosis; diabetes mellitus; hepatocellular carcinoma; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; metabolic syndrome.


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