Calamita Giuseppe, Portincasa Piero
Department of General and Environmental Physiology, University of Bari, Italy.
Expert Opin Ther Targets. 2007 Sep;11(9):1231-49. doi: 10.1517/14728222.11.9.1231.
Non-alcoholic fatty liver disease (NAFLD) is found in individuals who do not drink or abuse alcohol and represents a significant health burden for the general community. NAFLD is often associated with one or more features of the metabolic syndrome and has potential for evolution towards non-alcoholic steatohepatitis (NASH), the necro-inflammatory form of liver steatosis. The most worrisome evolutive events in a subgroup of NASH patients include advanced liver fibrosis, cirrhosis, and hepatocellular carcinoma. Pathophysiology of NAFLD/NASH is complex, but studies point to a pre-eminent role of oxidative stress and lipid peroxidation in the liver, including early mitochondrial dysfunction. Changes follow an insulin resistance status with a background of a chronic pro-inflammatory status due to an excess of visceral adiposity. Although no established therapy exists for NAFLD/NASH, potential therapeutic approaches are discussed in this review.
非酒精性脂肪性肝病（NAFLD）在不饮酒或不滥用酒精的个体中被发现，对普通人群构成了重大的健康负担。NAFLD通常与代谢综合征的一种或多种特征相关，并且有向非酒精性脂肪性肝炎（NASH，肝脏脂肪变性的坏死性炎症形式）发展的可能性。NASH患者亚组中最令人担忧的进展性事件包括晚期肝纤维化、肝硬化和肝细胞癌。NAFLD/NASH的病理生理学很复杂，但研究表明氧化应激和肝脏脂质过氧化起着重要作用，包括早期线粒体功能障碍。这些变化继发于胰岛素抵抗状态，并伴有由于内脏肥胖过多导致的慢性促炎状态背景。尽管目前尚无针对NAFLD/NASH的确立疗法，但本综述讨论了潜在的治疗方法。
