Department of Gastroenterology, Hepatology & Nutrition, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
J Clin Gastroenterol. 2012 Jul;46(6):457-67. doi: 10.1097/MCG.0b013e31824cf51e.
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in adults and children and is currently the third most common indication for liver transplantation in North America. Its pathogenesis is thought to be secondary to multiple "hits" derived from the dietary components, adipose tissue, immune system, and intestinal microbiota. Lack of physical activity may contribute as well. Nutrients may exert their effect directly or through alteration of the intestinal microbiota. Research focusing on specific dietary components predisposing to NAFLD has shown conflicting results. Total energy intake, and macronutrients, has been linked to the development of NAFLD. Fructose not only contributes to hepatic steatosis but may trigger inflammatory signals as well. Polyunsaturated fatty acids are thought to exert anti-inflammatory effects. The role of vitamins as well as minerals in this field is actively being investigated. In this review, we discuss the evidence-linking macronutrients (such as carbohydrates and fat in general and fructose, fiber, short chain fatty acids, polyunsaturated fatty, and choline specifically) and micronutrients (such as vitamin E and C and minerals) with the development and treatment of NAFLD. We also discuss the literature on physical activity and NAFLD.
非酒精性脂肪性肝病 (NAFLD) 是成人和儿童最常见的肝病病因，目前是北美第三大肝移植指征。其发病机制被认为继发于源自饮食成分、脂肪组织、免疫系统和肠道微生物群的多种“打击”。缺乏身体活动也可能起作用。营养素可能通过直接作用或通过改变肠道微生物群发挥作用。专注于导致 NAFLD 的特定饮食成分的研究结果相互矛盾。总能量摄入和宏量营养素与 NAFLD 的发生有关。果糖不仅导致肝脂肪变性，而且可能引发炎症信号。多不饱和脂肪酸被认为具有抗炎作用。维生素和矿物质在这一领域的作用正在积极研究中。在这篇综述中，我们讨论了将宏量营养素（如碳水化合物和一般脂肪以及果糖、纤维、短链脂肪酸、多不饱和脂肪酸和胆碱）和微量营养素（如维生素 E 和 C 以及矿物质）与 NAFLD 的发生和治疗联系起来的证据。我们还讨论了关于体力活动和 NAFLD 的文献。
