非酒精性脂肪肝的发病机制及肠促胰素在治疗中的研究进展

Nonalcoholic fatty liver disease: Pathogenesis and incretin based therapies

非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)是代谢综合征重要组成部分,目前治疗方法主要以改善生活方式和调整饮食结构为主,尚缺乏针对性药物.肠促胰素是肠道内分泌细胞分泌的胃肠激素,主要通过葡萄糖浓度依赖模式刺激胰岛素的分泌,胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)类降糖药物是用于治疗2型糖尿病的新型药物,其中包括GLP-1类似物和二肽基肽酶-4(dipeptidyl peptidase 4)抑制剂.基础及临床研究表明,肠促胰素可通过多种机制发挥对NAFLD的改善作用,但肠促胰素对NAFLD治疗的长期安全性仍需要进一步研究.

Nonalcoholic fatty liver disease is considered a hepatic manifestation of metabolic syndrome（MS）.The current treatment of non-alcoholic fatty liver disease（NAFLD）principally involves amelioration of MS components by lifestyle modification.Effective pharmacological agents for fatty liver treatment are lacking.Incretins are gut derived hormones secreted into the circulation in response to nutrient ingestion that can enhance glucose-stimulated insulin secretion,and represent a new class of drugs for treatment of type 2 diabetes,including glucagonlike peptide 1 analogues and dipeptidyl aminopeptidase 4 inhibitors.There are several experimental and clinical trials exploring the efficacy of incretin based therapies in NAFLD treatment,however,further studies are needed to assess the long-term effect of incretin based therapies on NAFLD.