Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
Semin Liver Dis. 2018 Nov;38(4):357-365. doi: 10.1055/s-0038-1670656. Epub 2018 Oct 24.
Exertional heat stroke most commonly develops following prolonged levels of aerobic activity in a warm or humid environment. Hypoperfusion of the vital organs along with activation of the inflammasome can lead to progressive and potentially fatal multiorgan failure including acute liver failure. In the United States, herbal and dietary supplements that are marketed to improve performance, strength, and weight loss are increasingly being used by both amateur and professional athletes. Consumption of bodybuilding supplements that contain androgenic anabolic steroids can lead to adverse hepatic effects ranging from asymptomatic serum aminotransferase elevations to severe cholestatic hepatitis with prolonged jaundice. Various non-bodybuilding nutritional supplements that contain a mixture of botanicals, caffeine, and chemicals have also been associated with idiosyncratic hepatotoxicity. In particular, green tea extract derivatives that contain epigallocatechin gallate are hepatotoxic in animal models and have been associated with severe acute hepatocellular injury in humans.
运动性热射病最常发生于在温暖或潮湿环境中长时间进行有氧运动之后。重要器官的低灌注以及炎症小体的激活可导致进行性和潜在致命的多器官衰竭，包括急性肝衰竭。在美国， marketed to improve performance, strength, and weight loss 的草药和膳食补充剂，越来越多地被业余和职业运动员使用。含有雄激素合成代谢类固醇的健美补充剂的摄入会导致从无症状的血清转氨酶升高到伴有长时间黄疸的严重胆汁淤积性肝炎等各种肝损伤。含有植物混合物、咖啡因和化学物质的各种非健美营养补充剂也与特发性肝毒性有关。特别是含有表没食子儿茶素没食子酸酯的绿茶提取物衍生物在动物模型中具有肝毒性，并与人类严重的急性肝细胞损伤有关。
