肠道菌群代谢物短链脂肪酸改善非酒精性脂肪肝病的作用研究进展

Research progress in roles of short-chain fatty acids,metabolites of intestinal flora,in improving non-alcoholic fatty liver disease

非酒精性脂肪肝在全球范围内的发病率日益升高,且已成为肝硬化和肝细胞癌最大的潜在风险。肠道微生物群被认为是代谢器官之一,与多种疾病的发生发展密切相关。目前,肠道微生物群在非酒精性脂肪肝病发展中的作用已成为研究热点,调节肠道菌群及其代谢物是治疗非酒精性脂肪肝病的新型靶点,但其作用机制尚未完全阐明。菌群代谢物改善非酒精性脂肪肝的机制与“多重打击”有关。本文综述近几年国内外肠道菌群代谢物短链脂肪酸改善非酒精性脂肪肝病的机制,如改善脂代谢紊乱、恢复胰岛素敏感性、修复肠道屏障功能和降低氧化应激水平,涉及解偶联蛋白2/腺苷酸活化激酶/乙酰辅酶A羧化酶和禁食诱导脂肪因子/脂蛋白脂酶等多个信号途径,以期为临床应用提供参考。

The incidence of non-alcoholic fatty liver disease(NAFLD) is increasing worldwide and has become the biggest potential risk for cirrhosis and hepatocellular carcinoma.Intestinal microbiota are considered one of the metabolic organs and closely related to the occurrence and development of many diseases.The role of intestinal microbiota in the development of non-alcoholic fatty liver disease has become a hotspot.Regulation of intestinal microbiota is a new target for the treatment of NAFLD,but its mechanism has not been fully clarified.Several studies have linked the mechanism by which microbiota metabolites improve NAFLD to a "multiple hit".This paper reviews the findings about the mechanism by which short-chain fatty acids improve NAFLD by improving lipid metabolism disorders,restoring insulin sensitivity,repairing the intestinal barrier function,and reducing oxidative stress levels.Multiple signaling pathways are involved,such as uncoupling protein 2-adenosine activated kinaseacetyl coenzyme A carboxylase and fasting induced fat factor/lipoprotein lipase in order to provide reference for clinical applications.