Second Medical Clinic, Department of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece; Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Second Medical Clinic, Department of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
Metabolism. 2015 Jan;64(1):60-78. doi: 10.1016/j.metabol.2014.10.012. Epub 2014 Oct 23.
Leptin, the first described adipokine, interplays with hepatic metabolism. The aim of this review was to summarize available data on the association between leptin and nonalcoholic fatty liver disease (NAFLD). Leptin has a potential dual action on NAFLD experimental models, exerting a possible anti-steatotic, but also a proinflammatory and profibrogenic action. Observational clinical studies have shown higher or similar leptin levels between simple steatosis and nonalcoholic steatohepatitis (NASH) compared with controls. Interventional studies showed that circulating leptin diminishes together with body mass index after successful weight loss following lifestyle modifications or bariatric surgery. Studies providing evidence for the effect of other medications on leptin levels in NAFLD populations are limited and of low power. Data from small studies claim that recombinant leptin administration had a possibly beneficial effect on steatosis, but not fibrosis, in NAFLD patients with hypoleptinemia. Although the aforementioned dual leptin action has not yet been validated in humans, leptin administration in NAFLD patients with normoleptinemia or hyperleptinemia is discouraged. Further well-controlled studies in cautiously selected populations are needed to elucidate whether leptin has any prognostic and therapeutic role in NAFLD patients.
瘦素，即首个被描述的脂肪因子，与肝脏代谢相互作用。本综述旨在总结有关瘦素与非酒精性脂肪性肝病（NAFLD）之间关联的现有数据。瘦素对 NAFLD 实验模型具有潜在的双重作用，可能具有抗脂肪变性作用，但也具有促炎和促纤维化作用。观察性临床研究表明，与对照组相比，单纯性脂肪变性和非酒精性脂肪性肝炎（NASH）之间的瘦素水平更高或相似。干预性研究表明，在生活方式改变或减肥手术后成功减肥后，循环瘦素与体重指数一起下降。提供关于其他药物对 NAFLD 人群中瘦素水平影响的证据的研究有限且效力较低。来自小型研究的数据声称，重组瘦素给药对低瘦素血症的 NAFLD 患者的脂肪变性可能有有益作用，但对纤维化无作用。尽管上述瘦素的双重作用尚未在人类中得到验证，但不鼓励在正常瘦素血症或高瘦素血症的 NAFLD 患者中使用瘦素。需要进一步在谨慎选择的人群中进行精心设计的研究，以阐明瘦素在 NAFLD 患者中是否具有任何预后和治疗作用。
