非酒精性脂肪性肝病及纤维化程度与慢性肾脏病关系的研究进展

Research advances in relationship between non-alcoholic fatty liver disease and its degree of fibrosis and chronic kidney disease

非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)不仅造成肝脏损伤,也累及肝外器官,既往研究多集中于其与心血管疾病的联系,现在越来越多的研究表明,NAFLD及纤维化程度与慢性肾脏病(chronic kidney disease, CKD)关系密切。本文将概述近年来国内外针对两者关系所做的诸多研究,并重点阐述两者相关的可能发生机制,如胰岛素抵抗、氧化应激、促炎促纤维化促凝血因子的增加、促动脉粥样硬化血脂异常、肾素-血管紧张素系统的激活和肠道菌群失调等,为临床上从共同机制探寻同时治疗这两种疾病的治疗方案提供新思路,并为医务人员和相关患者敲醒警钟。

Non-alcoholic fatty liver disease (NAFLD) not only causes liver damage, but also involves extrahepatic organs. Previous studies have focused on its association with cardiovascular diseases accumulating evidence suggests that NAFLD may be associated with an increased prevalence and incidence of chronic kidney disease (CKD). In this article, the evidence and possible mechanisms of NAFLD related to CKD were reviewed, such as insulin resistance, oxidative stress and the release of proinflammatory, procoagulant, pro-oxidant and profibrogenic mediators, activation of the renin-angiotensin system, intestinal dysbiosis and so on. We hope it will provide new ideas for the simultaneous treatment of these two diseases, and to alert the medical staff and related patients.