非酒精性脂肪性肝病与糖尿病

Non-alcoholic fatty liver disease and diabetes mellitus

非酒精性脂肪性肝病(NAFLD)是从简单的脂肪变性(又名非酒精性脂肪肝)发展到非酒精性脂肪性肝炎(NASH)以及肝硬化、肝癌的一系列疾病谱。NAFLD反映了疾病严重程度的频谱性改变,它并非单一的代谢紊乱。本文从NAFLD的定义着手,讲述了肝脂肪变性的评估和量化,NAFLD的流行病学和发病机制,以及与NAFLD相关的内分泌代谢紊乱。饮食和肠道菌群可促进NAFLD的发生和发展。基于流行病学、饮食习惯和肥胖等相关因素,糖尿病与NAFLD之间关系密切,二者形成了恶性循环。饮食及药物干预可在一定程度上缓解NAFLD与糖尿病的发生及发展。

Non-alcoholic fatty liver disease（NAFLD）is a spectrum of disorders ranging from simple steatosis（non-alcoholic fatty liver,NAFL）to non-alcoholic steatohepatitis（NASH）,cirrhosis and cancer.As a spectrum of severity,NAFLD is not a single metabolic disorder.This article begins with the definition of NAFLD,describes the assessment and quantification of hepatic steatosis,the epidemiology and pathogenesis of NAFLD,and the endocrine and metabolic disorders associated with NAFLD.Diet and intestinal flora can promote the occurrence and development of NAFLD.Based on epidemiology,dietary habits and obesity and other related factors,diabetes and NAFLD are closely related.Furthermore,the two have formed a vicious circle.To some extent,diet and drug intervention can alleviate the incidence and development of NAFLD and diabetes mellitus.