Han Eugene, Lee Yong Ho
Division of Endocrinology and Metabolism, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Graduate School, Yonsei University College of Medicine, Seoul, Korea.
Diabetes Metab J. 2017 Dec;41(6):430-437. doi: 10.4093/dmj.2017.41.6.430. Epub 2017 Nov 17.
As the number of individuals with non-alcoholic fatty liver disease (NAFLD) has increased, the influence of NAFLD on other metabolic diseases has been highlighted. Accumulating epidemiologic evidence indicates that NAFLD not only affects the liver but also increases the risk of extra-hepatic diseases such as type 2 diabetes mellitus, metabolic syndrome, dyslipidemia, hypertension, cardiovascular or cerebrovascular diseases, and chronic kidney disease. Non-alcoholic steatohepatitis, an advanced type of NAFLD, can aggravate these inter-organ relationships and lead to poorer outcomes. NAFLD induces insulin resistance and exacerbates systemic chronic inflammation and oxidative stress, which leads to organ dysfunction in extra-hepatic tissues. Although more research is needed to identify the pathophysiological mechanisms and causal relationship between NAFLD and cardiometabolic and renal diseases, screening for heart, brain, and kidney diseases, risk assessment for diabetes, and a multidisciplinary approach for managing these patients should be highly encouraged.
随着非酒精性脂肪性肝病(NAFLD)患者数量的增加,NAFLD对其他代谢性疾病的影响日益凸显。越来越多的流行病学证据表明,NAFLD不仅影响肝脏,还会增加肝外疾病的风险,如2型糖尿病、代谢综合征、血脂异常、高血压、心血管或脑血管疾病以及慢性肾脏病。非酒精性脂肪性肝炎作为NAFLD的一种晚期类型,会加剧这些器官间的关联,并导致更差的预后。NAFLD会诱发胰岛素抵抗,加剧全身慢性炎症和氧化应激,进而导致肝外组织器官功能障碍。尽管需要更多研究来确定NAFLD与心脏代谢及肾脏疾病之间的病理生理机制和因果关系,但仍应大力鼓励对心脏、大脑和肾脏疾病进行筛查,对糖尿病进行风险评估,并采取多学科方法来管理这些患者。