Intersektorales Management von Patienten mit unklarer Leberwerterhöhung und nichtalkoholischer Fettlebererkrankung (NAFLD)

Zusammenfassung

Die Prävalenz der Fettlebererkrankung hat in den letzten Jahren auch in Deutschland erheblich zugenommen. Sie gehört mit geschätzten 18 Mio. betroffenen Bundesbürgern mittlerweile zu den großen Volkskrankheiten. Sie gilt ferner als ein relevanter unabhängiger Risikofaktor für weitere kardiovaskuläre Volkskrankheiten wie Herzinfarkt oder Schlaganfall. Schließlich begünstigt ein Diabetes mellitus die Entstehung einer Fettleber und eines ungünstigeren Verlaufs der Fettlebererkrankung. Vor dem Hintergrund der hohen Prävalenz und Komplikationen kommt das deutsche Gesundheitssystem bei der Versorgung dieser Patienten an die Grenzen seiner Ressourcen.

Daher ist eine enge Abstimmung und Vernetzung aller an der Behandlung dieser Patienten beteiligten Fachgebiete und Versorgungsbereiche essenziell notwendig. In einem Expertenkonsensus unter Einbindung niedergelassener Kollegen und Krankenhausärzten der Gastroenterologie, Endokrinologie, Kardiologie, Hausärzten und Labormedizinern sowie in enger Abstimmung mit Patientenvertretern haben wir ein Konzept der Versorgung dieser Patienten im deutschen Gesundheitssystem entworfen. Darin werden auch notwendige Entwicklungen adressiert. Neben dem Nutzen als praxisnahem Leitfaden soll dies auch die gesundheitspolitische Arbeit unterstützen, insbesondere bei der Erarbeitung von praktischen Versorgungslösungen auf medizinischer Ebene.

Abstract

The prevalence of fatty liver disease has increased significantly in Germany in recent years. With an estimated 18 million German citizens being affected, it is now among the most prevalent diseases. Furthermore, it is also considered a relevant and independent risk factor for other common cardiovascular diseases such as heart attack or stroke. Finally, diabetes mellitus promotes the development of and an unfavorable course of fatty liver disease. Given the high prevalence and complications, the German healthcare system is reaching its limits.

Therefore, close coordination of all healthcare providers and specialists involved in the treatment of these patients is essential. In an expert consensus involving private practice and hospital doctors from the fields of gastroenterology, endocrinology, cardiology, general practitioners and laboratory physicians, as well as in close coordination with patient representatives, we have designed a concept for the care of these patients in the German healthcare system. Necessary developments are also addressed. In addition to being useful as a practical guideline, this should also support health policy work, especially in the development of practical care solutions at the medical level.

Schlüsselwörter

Fettleber - NAFLD - NASH - Diabetes - Übergewicht - Adipositas - Konsensus - Leitlinie

Keywords

fatty liver - NAFLD - NASH - Diabetes - overweight - adipositas - consensus - guideline

Publication History

Received: 15 March 2022

Accepted after revision: 22 August 2022

Article published online:
15 February 2023

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