비알코올성 지방간질환에 대한 이해와 비약물적 중재 및 측정지표에 대한 문헌분석

김나현

서지반출

국문초록

비만은 건강을 위협하고 삶의 질을 저하시키며, 각종 질병을 유발시켜 수명을 단축시키는 주요 건강문제가 되고 있다. 과체중과 비만은 대사증후군, 심혈관계 질환, 암, 근골격계 질환뿐만 아니라 비알코올성 지방간질환(nonalcoholic fatty liver disease, NAFLD)과 같은 간 합병증을 일으키기도 한다. NAFLD는 비만과 인슐린 저항성으로 인한 간내 대사증후군이 발현한 상태로(Cho, 2010), 음주경력이 없거나 주 40 g 미만의 알코올섭취에도 불구하고 알코올성 간염과 유사하게 간세포내 중성지방이 과다하게 축적되어 있는 상태를 말한다(Adams, Sanderson, Lindor, & Angulo, 2005). 여기에는 간세포에 지방의 과도한 축적만 있는 단순 지방간(simple steatosis) 간세포 괴사와 염증 및 섬유화를 동반한 비알코올성 지방간염(nonalcoholic steatohepatitis, NASH) 및 이것이 진행되어 간경변증이 초래되는 경우까지 모두 포함된다. 심할 경우에는 간세포암으로까지 진행될 수 있어(Sohn & Kim, 2010) 만성 간질환 분야에서 큰 관심을 모으고 있다. 또한 최근의 보고에 의하면 NAFLD는 심혈관질환 및 대사성질환의 발생 및 진행과정과 관련이 있는 주요 선행 위험지표이기도 하다(Reynoso & Lavine, 2012).

영문초록

Purpose: This study was intended to analyze the types and measurement parameters of non-pharmacological interventional studies for nonalcoholic fatty liver disease (NAFLD). Methods: NAFLD related literatures were systematically reviewed. The existing literatures were searched electronically using the data base of PubMed, a Medline data base of the National Library of Medicine with the key words of nonalcoholic fatty liver disease, NAFLD, nonalcoholic steatohepatitis, and NASH. The criteria for inclusion in this review were 1) non-pharmacological intervention, 2) human, 3) English. Finally, 20 articles were included in the review. Results: The major findings of this study were as follows: 1) the types of non-pharmacological intervention were exercise (35%), caloric restriction (30%), and lifestyle modification with combination both of exercise and caloric restriction (35%), 2) Almost all studies adopted various measurement parameters derived from pathophysiological mechanism-based biomarkers such as anthropometric indices, biochemical parameters, body fat mass, and liver biopsy results. Conclusion: Non-pharmacological interventions have been reported to be effective to improve NAFLD status, and many objective biomarkers confirmed supported these findings. Therefore, the development of nursing interventions for NAFLD subjects is needed and the consideration of using mechanism-based biomarkers is suggested to verify nursing outcomes objectively.

키워드

Nonalcoholic fatty liver disease Non-pharmacological intervention study 비알코올성 지방간질환 비약물적 중재 연구

참고문헌 (30건)

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