Cave Matthew, Deaciuc Ion, Mendez Christian, Song Zhenyuan, Joshi-Barve Swati, Barve Shirish, McClain Craig
Department of Medicine, University of Louisville Medical Center, Louisville, KY 40292, USA.
J Nutr Biochem. 2007 Mar;18(3):184-95. doi: 10.1016/j.jnutbio.2006.12.006.
More than 20% of Americans have nonalcoholic fatty liver disease (NAFLD), and this is, by far, the leading cause of abnormal liver enzymes in the United States. Nonalcoholic steatohepatitis (NASH), a more serious form of NAFLD, can proceed to cirrhosis and even hepatocellular carcinoma. These liver diseases represent the hepatic component of the metabolic syndrome, and this spectrum of liver disease represents a major health problem both in the United States and worldwide. Hepatic steatosis is closely linked to nutrition, including obesity, possibly high-fructose corn syrup consumption and consumption of certain types of fats. There are a variety of second insults or "hits" that appear to transform simple steatosis into NASH, with some of these second hits including certain proinflammatory cytokines, oxidative stress and possibly industrial toxins. In certain underdeveloped countries, it appears likely that industrial toxins play a role in NASH, and there is increasing interest in the potential interaction of industrial toxins and nutrients. Moreover, optimal therapy for NAFLD appears to include lifestyle modification with exercise, diet and weight loss. Certain nutrients may also be of benefit. Important areas for future research are the effect(s) of nutritional supplements on NAFLD/NASH and the effects of industrial toxins.
超过20%的美国人患有非酒精性脂肪性肝病（NAFLD），而且到目前为止，这是美国肝酶异常的首要原因。非酒精性脂肪性肝炎（NASH）是NAFLD的一种更严重形式，可发展为肝硬化甚至肝细胞癌。这些肝脏疾病是代谢综合征的肝脏组成部分，并且这种肝病谱在美国乃至全球都是一个主要的健康问题。肝脂肪变性与营养密切相关，包括肥胖、可能的高果糖玉米糖浆摄入以及某些类型脂肪的摄入。有多种二次损伤或“打击”似乎会将单纯性脂肪变性转变为NASH，其中一些二次打击包括某些促炎细胞因子、氧化应激以及可能的工业毒素。在某些欠发达国家，工业毒素似乎在NASH中起作用，并且人们对工业毒素与营养物质之间的潜在相互作用越来越感兴趣。此外，NAFLD的最佳治疗方法似乎包括通过运动、饮食和减肥来改变生活方式。某些营养物质可能也有益处。未来研究的重要领域是营养补充剂对NAFLD/NASH的影响以及工业毒素的影响。
