Department of Physiology and Pharmacology, Center for Hypertension and Personalized Medicine, University of Toledo College of Medicine , Toledo, Ohio.
Department of Physiology and Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center , Jackson, Mississippi.
Am J Physiol Gastrointest Liver Physiol. 2018 Jun 1;314(6):G668-G676. doi: 10.1152/ajpgi.00026.2018. Epub 2018 Mar 1.
The buildup of fat in the liver (hepatic steatosis) is the first step in a series of incidents that may drive hepatic disease. Obesity is the leading cause of nonalcoholic fatty liver disease (NAFLD), in which hepatic steatosis progresses to liver disease. Chronic alcohol exposure also induces fat accumulation in the liver and shares numerous similarities to obesity-induced NAFLD. Regardless of whether hepatic steatosis is due to obesity or long-term alcohol use, it still may lead to hepatic fibrosis, cirrhosis, or possibly hepatocellular carcinoma. The antioxidant bilirubin and the enzyme that generates it, biliverdin reductase A (BVRA), are components of the heme catabolic pathway that have been shown to reduce hepatic steatosis. This review discusses the roles for bilirubin and BVRA in the prevention of steatosis, their functions in the later stages of liver disease, and their potential therapeutic application.
肝脏脂肪堆积（肝脂肪变性）是一系列可能导致肝病的事件的第一步。肥胖是导致非酒精性脂肪性肝病（NAFLD）的主要原因，肝脂肪变性可进展为肝病。慢性酒精暴露也会导致肝脏脂肪堆积，并且与肥胖引起的非酒精性脂肪性肝病有许多相似之处。无论肝脂肪变性是由于肥胖还是长期饮酒引起的，它仍然可能导致肝纤维化、肝硬化，甚至可能导致肝细胞癌。抗氧化剂胆红素和生成它的酶-胆红素还原酶 A（BVRA），是血红素分解代谢途径的组成部分，已被证明可减少肝脂肪变性。本综述讨论了胆红素和 BVRA 在预防脂肪变性中的作用、它们在肝病后期的功能，以及它们在治疗中的潜在应用。
