Department of Medicine, University of Helsinki, Helsinki, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland.
Lancet Diabetes Endocrinol. 2014 Nov;2(11):901-10. doi: 10.1016/S2213-8587(14)70032-4. Epub 2014 Apr 7.
Metabolic syndrome is a cluster of metabolic abnormalities that identifies people at risk of diabetes and cardiovascular disease, whereas non-alcoholic fatty liver disease (NAFLD) is defined as a disorder with excess fat in the liver due to non-alcoholic causes. Two key components of metabolic syndrome, glucose and triglycerides, are overproduced by the fatty liver. The liver is therefore a key determinant of metabolic abnormalities. The prevalence of both metabolic syndrome and NAFLD increases with obesity. Other acquired causes for both disorders include excessive intake of simple sugars and physical inactivity. Both disorders predict type 2 diabetes, cardiovascular disease, non-alcoholic steatohepatitis (NASH), and hepatocellular carcinoma. Because metabolic syndrome can be defined in many different ways, NAFLD might be a more direct predictor of these diseases. Half of people with NAFLD carry at least one variant (G) allele at rs738409 in the PNPLA3 gene, which is associated with high liver fat content. Steatosis in PNPLA3-associated NAFLD is not accompanied by features of metabolic syndrome. All forms of NAFLD increase the risk of NASH, cirrhosis, and hepatocellular carcinoma.
代谢综合征是一组代谢异常，可识别出患糖尿病和心血管疾病风险的人群，而非酒精性脂肪性肝病 (NAFLD) 则定义为由于非酒精原因导致肝脏脂肪过多的疾病。代谢综合征的两个关键组成部分，葡萄糖和甘油三酯，是由脂肪肝过量产生的。因此，肝脏是代谢异常的关键决定因素。随着肥胖，代谢综合征和 NAFLD 的患病率都在增加。这两种疾病的其他后天原因包括过量摄入简单糖和缺乏身体活动。这两种疾病都可预测 2 型糖尿病、心血管疾病、非酒精性脂肪性肝炎 (NASH) 和肝细胞癌。由于代谢综合征可以用许多不同的方式来定义，因此 NAFLD 可能是这些疾病的更直接预测因素。一半的 NAFLD 患者在 PNPLA3 基因的 rs738409 处至少携带一个变异 (G) 等位基因，该基因与肝脏脂肪含量高有关。与 PNPLA3 相关的 NAFLD 的脂肪变性不伴有代谢综合征的特征。所有形式的 NAFLD 都会增加 NASH、肝硬化和肝细胞癌的风险。
