非酒精性脂肪肝发病机制的研究进展

Research progress on the pathogenesis of non-alcoholic fatty liver disease

非酒精性脂肪性肝病(NAFLD)指的是除酒精因素以及其他损伤肝脏因素共同作用下产生的肝脏病变性疾病,主要特征是肝细胞内堆积和沉积过多的脂肪,与遗传易感、胰岛素抵抗(IR)等因素具有一定相关。该疾病包括非酒精性脂肪肝性肝炎(NASH)、单纯脂肪肝(NAFL)和相关肝硬化疾病等。根据相关调查数据显示,在全球范围内NAFLD已经达到25%左右,其中糖尿病人群和肥胖人群中该疾病发病率已经超过70%,对患者的身心健康、生活质量等均造成了严重负面影响。该疾病现已成为影响人类健康的一项重要公共健康问题,因此加强对该疾病发病机制的相关研究,对提升疾病控制效果,改善患者生存质量均具有重要的作用和意义。但是目前尚未完全明确该疾病的发病机制,除“二次打击”理论以外,认为该疾病的发生还可能与免疫系统调节紊乱、肠道菌群失调、氧化应激、线粒体功能异常或细胞自噬等多项因素有关。现针对NAFLD的相关发病机制和影响因素作出如下综述,旨在为该疾病的临床相关研究和治疗提供有力的参考依据。

Non-alcoholic fatty liver disease(NAFLD) refers to a pathological disease of the liver that is caused by the combined nonaction of alcohol and other factors that damage the liver. The main feature is the accumulation and deposition of excessive fat in liver cells, and genetic susceptibility, insulin resistance(IR) and other factors are related to some extent. The disease includes non-alcoholic fatty liver hepatitis(NASH), simple fatty liver(NAFL) and related cirrhosis diseases. According to relevant survey data,NAFLD has reached about 25% worldwide, among which the incidence of the disease has exceeded 70% in diabetic and obese people, which has caused serious negative effects on the physical and mental health and quality of life of patients. The disease has now become an important public health issue affecting human health. Therefore, strengthening the relevant research on the pathogenesis of the disease has an important role and significance in enhancing the effect of disease control and improving the quality of life of patients.However, the pathogenesis of the disease has not yet been fully clarified. In addition to the "second hit" theory, it is believed that the occurrence of the disease may also be related to many factors such as immune system modulation disorder, intestinal flora imbalance, oxidative stress, mitochondrial dysfunction, or autophagy. The following review is made for the related pathogenesis and influencing factors of NAFLD,aiming to provide a strong reference for the clinical research and treatment of the disease.