理想心血管健康与代谢功能障碍相关性脂肪性肝病关系的研究进展

Research progress on ideal cardiovascular health reducing risk of metabolic dysfunction-associated steatotic liver disease

随着肥胖和糖尿病的流行, 代谢功能障碍相关性脂肪性肝病(MASLD)的患病率迅速升高, 已成为目前最常见的慢性肝病之一。大量研究显示MASLD的发生及其严重程度与心血管疾病风险增加密切相关。2010年美国心脏协会提出了理想心血管健康的概念, 2022年提出了"理想心血管健康八项(LE8)", 包括4项理想心血管健康行为和4项理想心血管健康因素。旨在提供一种简单、直接的方法量化重要的心血管健康行为和因素, 从而为心血管疾病的预防提供靶标。值得注意的是, 新近的研究证实随着LE8评分升高, 在心血管疾病风险降低的同时MASLD的患病风险也降低。该文对有关MASLD患者理想心血管健康状况、理想心血管健康与MASLD发生发展的关系以及改善理想心血管健康对MASLD的防治意义的最新研究进展进行了综述, 以探讨理想心血管健康与MASLD的关系, 以及可否通过管理理想心血管健康行为与因素预防及管理MASLD患者。

With the increasing prevalence of obesity and diabetes mellitus,the incidence rate of metabolic dysfunction-associated steatotic liver disease(MASLD)is on the rise.MASLD has become the most common chronic liver disease,affecting more than 30%of the global population and causing serious social and economic burden.Numerous studies have shown that the development of MASLD is associated with an increased risk of heart and blood vessel disease(CVD).In 2010,the American Heart Association proposed the concept of ideal cardiovascular health(ICH);in 2022,the scoring criteria were updated with the introduction of the Life′s Essential 8(LE8),comprising 4 ideal cardiovascular behaviors(optimal diet,exercise,no smoking,mean sleep 7-9 h/d)and 4 ideal cardiovascular conditions(blood pressure<120/80 mmHg(1 mmHg=0.133 kPa)with no medication,no history of diabetes mellitus and fasting blood glucose<5.6 mmol/L or HbA1c<5.7%,non-high density lipoprotein cholesterol<3.36 mmol/L,body mass index<25 kg/m 2).It aims to provide clear,actionable goals for CVD prevention by providing a direct,simple way to quantify health behaviors.A growing number of studies also confirm that the higher level of LE8 metrics is closely associated with the lower risk of MASLD.This article reviews the latest research progress on ICH metrics for reducing risk of MASLD,in order to provide references for early and effective prevention and comprehensive management of MASLD patients.