Schindhelm Roger K, Diamant Michaela, Dekker Jacqueline M, Tushuizen Maarten E, Teerlink Tom, Heine Robert J
Department of Endocrinology/Diabetes Centre, VU University Medical Centre, 1007 MB Amsterdam, The Netherlands.
Diabetes Metab Res Rev. 2006 Nov-Dec;22(6):437-43. doi: 10.1002/dmrr.666.
For a long time, hepatic steatosis was believed to be a benign condition. Only recently, liver steatosis, also termed non-alcoholic fatty liver disease (NAFLD), has gained much interest. In most cases of NAFLD, a condition regarded as the hepatic component of the metabolic syndrome, the enzyme alanine aminotransferase (ALT) is elevated and consequently has been used as a marker for NAFLD. More recently, several cross-sectional and prospective studies have demonstrated associations of this liver enzyme with features of the metabolic syndrome and type 2 diabetes mellitus. This review discusses the biochemical and metabolic properties of ALT, its applicability as a marker of NAFLD and describes its possible role in the pathogenesis of the metabolic syndrome and type 2 diabetes mellitus and subsequent cardiovascular disease. In addition, treatment strategies to ameliorate NAFLD and the associated risks are discussed.
长期以来，肝脂肪变性一直被认为是一种良性病症。直到最近，肝脂肪变性，也被称为非酒精性脂肪性肝病（NAFLD），才引起了广泛关注。在大多数被视为代谢综合征肝脏组成部分的NAFLD病例中，丙氨酸氨基转移酶（ALT）升高，因此一直被用作NAFLD的标志物。最近，几项横断面研究和前瞻性研究表明，这种肝酶与代谢综合征和2型糖尿病的特征有关。本综述讨论了ALT的生化和代谢特性、其作为NAFLD标志物的适用性，并描述了其在代谢综合征和2型糖尿病以及随后的心血管疾病发病机制中的可能作用。此外，还讨论了改善NAFLD及相关风险的治疗策略。
