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
DOI:
https://doi.org/10.24950/rspmi.2522Palavras-chave:
Diabetes Mellitus Tipo 2, Doença Hepática Gorda Não Alcólica, Figado Gordo, Síndrome MetabólicoResumo
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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