非酒精性脂肪性肝病与胆红素:关系,机制和治疗前景

Nonalcoholic fatty liver disease and bilirubin: correlation, mechanism, and therapeutic perspectives

非酒精性脂肪性肝病(NAFLD)是多种因素所致的以肝细胞内脂肪过度沉积为主要特征的代谢相关性疾病。近年随着西式饮食和肥胖的流行,NAFLD的发病率也在逐渐提高,成为日益严重的公共健康问题。胆红素是血红素的代谢产物,是一种有效的抗氧化剂。研究发现胆红素水平与NAFLD的发病率呈负相关,但具体是哪种形式的胆红素在起主要保护作用目前尚有争议。胆红素的抗氧化性、降低胰岛素抵抗以及诱导线粒体功能等特性,被认为是其在NAFLD中起保护作用的原因。现总结NAFLD与胆红素的相关性、胆红素在NAFLD中起保护作用的机制,以及胆红素在治疗NAFLD中可能的临床应用。

Non-alcoholic fatty liver disease(NAFLD)is a metabolic-related disorder induced by multiple factors and mainly characterized by excessive fat buildup in hepatocytes.With the consumption of a Western-style diet and obesity prevalence in recent years,the incidence of NAFLD has gradually increased,becoming an increasingly serious public health problem.Bilirubin is a heme metabolite and a potent antioxidant.Studies have demonstrated that bilirubin levels have an inverse correlation with the incidence rate of NAFLD;however,which form of bilirubin plays the main protective role is still controversial.It is considered that the main protective mechanisms for NAFLD are bilirubin antioxidant properties,insulin resistance reduction,and mitochondrial function.This article summarizes the correlation,protective mechanism,and possible clinical application of NAFLD and bilirubin.