摘要:

非酒精性脂肪性肝病(NAFLD)在全球的發(fā)病率不斷上升,在美國(guó)等發(fā)達(dá)國(guó)家是導(dǎo)致慢性肝病的主要原因,將來(lái)也可能會(huì)是中國(guó)最常見(jiàn)的慢性肝病。NAFLD多發(fā)生于肥胖人群,然而瘦型NAFLD在全世界也很常見(jiàn)?？偨Y(jié)了最近瘦型NAFLD相關(guān)的研究,并闡述該病發(fā)病機(jī)制主要包括以下途徑:單核苷酸多態(tài)性改變是導(dǎo)致瘦人發(fā)生NAFLD的易患因素之一;由于腸道菌群改變以及骨骼肌萎縮使機(jī)體易發(fā)生多種代謝異常,如高血脂、高血尿酸、胰島素抵抗以及鐵代謝異常,代謝異常亦可促進(jìn)NAFLD的發(fā)生;此外,不健康的飲食習(xí)慣以及生活方式,易使脂肪在體內(nèi)蓄積,增加肝臟負(fù)荷。這些因素的共同作用最終導(dǎo)致了NAFLD的發(fā)生。然而,確切的發(fā)病機(jī)制仍需進(jìn)一步研究。

Abstract:

The incidence rate of nonalcoholic fatty liver disease(NAFLD) is continuously increasing in the world, and NAFLD is a major cause of chronic liver disease in developed countries such as the United States and may become the most common chronic liver disease in China in the future. NAFLD is often observed in the obese population; however, it is also commonly seen in lean individuals. This article summarizes the latest studies on lean NAFLD and elaborates on the following pathogeneses of this disease: the change in single nucleotide polymorphism is one of the predisposing factors for NAFLD in the lean population; the change of gut microbiota and sarcopenia may induce a variety of metabolic disorders including hyperlipidemia, hyperuricemia, insulin resistance, and iron metabolic disorders, and such metabolic disorders may promote the development of NAFLD; in addition, unhealthy dietary habits and lifestyle may contribute to the accumulation of fat and increase the burden of the liver. The combined effect of these factors eventually lead to the development of NAFLD, but further studies are still needed to clarify the pathogenesis of lean NAFLD.

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