Petta Salvatore, Valenti Luca, Bugianesi Elisabetta, Targher Giovanni, Bellentani Stefano, Bonino Ferruccio
Section of Gastroenterology, Di.Bi.M.I.S Policlinico Paolo Giaccone Hospital, University of Palermo, Italy.
Internal Medicine, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, University of Milan, Italy.
Dig Liver Dis. 2016 Mar;48(3):333-42. doi: 10.1016/j.dld.2015.10.027. Epub 2015 Nov 14.
The prevalence of fatty liver (steatosis) in the general population is rapidly increasing worldwide. The progress of knowledge in the physiopathology of fatty liver is based on the systems biology approach to studying the complex interactions among different physiological systems. Similarly, translational and clinical research should address the complex interplay between these systems impacting on fatty liver. The clinical needs drive the applications of systems medicine to re-define clinical phenotypes, assessing the multiple nature of disease susceptibility and progression (e.g. the definition of risk, prognosis, diagnosis criteria, and new endpoints of clinical trials). Based on this premise and in light of recent findings, the complex mechanisms involved in the pathology of fatty liver and their impact on the short- and long-term clinical outcomes of cardiovascular, metabolic liver diseases associated with steatosis are presented in this review using a new "systems medicine" approach. A new data set is proposed for studying the impairments of different physiological systems that have an impact on fatty liver in different subsets of subjects and patients.
全球普通人群中脂肪肝（脂肪变性）的患病率正在迅速上升。脂肪肝生理病理学知识的进展基于系统生物学方法，该方法用于研究不同生理系统之间的复杂相互作用。同样，转化医学和临床研究也应关注这些影响脂肪肝的系统之间的复杂相互作用。临床需求推动了系统医学的应用，以重新定义临床表型，评估疾病易感性和进展的多重性质（例如风险定义、预后、诊断标准以及临床试验的新终点）。基于这一前提并结合近期研究结果，本综述采用新的“系统医学”方法，阐述了脂肪肝病理过程中涉及的复杂机制及其对与脂肪变性相关的心血管、代谢性肝脏疾病短期和长期临床结局的影响。本文还提出了一个新的数据集，用于研究不同生理系统的损伤，这些损伤在不同的受试者和患者亚组中对脂肪肝产生影响。
