摘要
非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是一种以肝细胞内脂质积累大于肝重量 5%为典型特征的肝脏代谢性疾病.可从单纯性脂肪肝进展到非酒精性脂肪性肝炎、纤维化、肝硬化甚至肝细胞癌.NAFLD 常与超重/肥胖、2 型糖尿病及胰岛素抵抗等代谢功能障碍有关.近年来肠道微生物组学研究发现肠道菌群异常与代谢性疾病相关.近年来研究发现,肠道菌群产生的多种具有生物活性的代谢产物与 NAFLD发病及进展相关.随着研究的深入,越来越多的肠源性代谢产物被鉴定,如次级胆汁酸、短链脂肪酸、吲哚-3-丙酸、胆碱及其代谢物、内源性乙醇、咪唑丙酸、内毒素等.它们在肝脏脂肪累积、炎症损伤和氧化应激、纤维化等方面起重要作用,阻断这些环节也可能是具有临床价值的潜在治疗靶点.
Abstract
Non-alcoholic fatty liver disease(NAFLD)is a liver metabolic disease characterized by lipid accumula-tion in liver cells greater than 5%of liver weight.It can progress from simple fatty liver to nonalcoholic steatohepatitis,fibrosis,cirrhosis and hepatocellular carcinoma.NAFLD is often associated with metabolic dysfunction such as over-weight or obesity,type 2 diabetes and insulin resistance.In recent years,a variety of bioactive metabolites produced by intestinal flora are found associated with the onset and progression of NAFLD.With the deepening of research,more gut-derived metabolites have been identified,such as short-chain fatty acids,secondary bile acids,indole-3-propionic acid,choline and its metabolites,ethanol,imidazole propionate,endotoxin,etc.These gut-derived metabolites play an im-portant role in hepatic fat accumulation,inflammatory damage and oxidative stress,fibrosis,and may also be potential therapeutic targets with clinical value.
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