Katsiki Niki, Mikhailidis Dimitri P, Mantzoros Christos S
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK.
Metabolism. 2016 Aug;65(8):1109-23. doi: 10.1016/j.metabol.2016.05.003. Epub 2016 May 13.
Non-alcoholic fatty liver (NAFLD) is the most common liver disease worldwide, progressing from simple steatosis to necroinflammation and fibrosis (leading to non-alcoholic steatohepatitis, NASH), and in some cases to cirrhosis and hepatocellular carcinoma. Inflammation, oxidative stress and insulin resistance are involved in NAFLD development and progression. NAFLD has been associated with several cardiovascular (CV) risk factors including obesity, dyslipidemia, hyperglycemia, hypertension and smoking. NAFLD is also characterized by atherogenic dyslipidemia, postprandial lipemia and high-density lipoprotein (HDL) dysfunction. Most importantly, NAFLD patients have an increased risk for both liver and CV disease (CVD) morbidity and mortality. In this narrative review, the associations between NAFLD, dyslipidemia and vascular disease in NAFLD patients are discussed. NAFLD treatment is also reviewed with a focus on lipid-lowering drugs. Finally, future perspectives in terms of both NAFLD diagnostic biomarkers and therapeutic targets are considered.
非酒精性脂肪性肝病(NAFLD)是全球最常见的肝脏疾病,可从单纯性脂肪变性发展为坏死性炎症和纤维化(导致非酒精性脂肪性肝炎,NASH),在某些情况下还会发展为肝硬化和肝细胞癌。炎症、氧化应激和胰岛素抵抗参与了NAFLD的发生和发展。NAFLD与多种心血管(CV)危险因素相关,包括肥胖、血脂异常、高血糖、高血压和吸烟。NAFLD还具有致动脉粥样硬化性血脂异常、餐后血脂过多和高密度脂蛋白(HDL)功能障碍的特征。最重要的是,NAFLD患者发生肝脏疾病和心血管疾病(CVD)的发病率和死亡率均增加。在这篇叙述性综述中,讨论了NAFLD、血脂异常与NAFLD患者血管疾病之间的关联。还对NAFLD治疗进行了综述,重点是降脂药物。最后,考虑了NAFLD诊断生物标志物和治疗靶点方面的未来前景。