Metabolic Dysfunction-Associated Steatotic Liver Disease: An Update on Screening and Therapeutic Options

Doença Hepática Esteatótica Associada a Disfunção Metabólica: Uma Atualização do Rastreio e Opções Terapêuticas

Autores

  • Luís Fernandes Serviço de Medicina Interna, Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal https://orcid.org/0000-0002-3977-4658
  • Sofia Osório de Castro Serviço de Medicina Interna, Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal
  • Sara S. Santos Serviço de Medicina Interna, Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal
  • Sérgio Gomes Ferreira Serviço de Medicina Interna, Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal
  • Luís Andrade Serviço de Medicina Interna, Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal
  • Cátia Henriques Serviço de Medicina Interna, Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal

DOI:

https://doi.org/10.24950/rspmi.2522

Palavras-chave:

Diabetes Mellitus Tipo 2, Doença Hepática Gorda Não Alcólica, Figado Gordo, Síndrome Metabólico

Resumo

A doença hepática esteatótica associada a disfunção metabólica, em inglês metabolic dysfunction-associated steatotic liver disease (MASLD), previamente conhecida como fígado gordo não alcoólico, é das formas mais comuns de doença hepática crónica, estando particularmente associada com a obesidade e diabetes mellitus tipo 2. A sua prevalência tem aumentado nos últimos anos, afetando, neste momento, cerca de 25% da população mundial. A génese da sua fisiopatologia reside na insulinorresistência e acumulação de gordura no interior dos hepatócitos. Existem vários scores clínicos que permitem o seu rastreio de forma custo-efetiva, como o FIB-4 e NFS. Apesar de ser considerada como gold-standard, a biópsia hepática pode ser dispensada na maioria das vezes através do uso da elastografia hepática. Inúmeros fármacos utilizados na diabetes têm potencialidade terapêutica na doença hepática esteatótica associada a disfunção metabólica, sendo a classe mais estudada os agonistas do recetor GLP-1. A associação fisiopatológica bidirecional entre a doença hepática esteatótica associada a disfunção metabólica e a diabetes irá permitir o desenvolvimento desta área e o surgimento de novas terapêuticas.

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Figura 1: Diferentes estádios da MASLD e respetivas atuações. Adaptado com autorização de Pandyarajan et al.21 CHC – carcinoma hepatocelular.

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Publicado

26-09-2024

Como Citar

1.
Fernandes L, Osório de Castro S, S. Santos S, Gomes Ferreira S, Andrade L, Henriques C. Metabolic Dysfunction-Associated Steatotic Liver Disease: An Update on Screening and Therapeutic Options: Doença Hepática Esteatótica Associada a Disfunção Metabólica: Uma Atualização do Rastreio e Opções Terapêuticas. RPMI [Internet]. 26 de Setembro de 2024 [citado 14 de Dezembro de 2024];31(3):153-60. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/2522

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