a Department of Exercise Physiology, Sari Branch , Islamic Azad University , Sari , Iran.
b Department of Physical Education, Tabriz Branch , Islamic Azad University , Tabriz , Iran.
Eur J Sport Sci. 2019 Aug;19(7):994-1003. doi: 10.1080/17461391.2019.1571114. Epub 2019 Feb 8.
Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disorder which is associated with accumulation of fats in the liver. It causes a wide variety of pathological effects such as non-alcoholic steatohepatitis (NASH) and cirrhosis, insulin resistance, obesity, hypertension, dyslipidaemia, diabetes and cardiovascular disease. The molecular mechanisms that cause the initiation and progression of NAFLD are not fully understood. Oxidative stress (OS) induced by reactive oxygen species (ROS) and inflammation are likely a significant mechanism which can lead to hepatic cell death and tissue injury. Mitochondrial abnormalities, down-regulation of several antioxidant enzymes, glutathione (GSH) depletion and decreased activity of GSH-dependent antioxidants, accumulation of leukocytes and hepatic inflammation are the major sources of ROS overproduction in NAFLD. Excessive production of ROS suppresses the capacity of other antioxidant defence systems in NAFLD and causes further oxidative damage. Regular exercise can be considered as an effective strategy for treatment of NAFLD. It improves NAFLD by reducing intrahepatic fat content, increasing β-oxidation of fatty acids, inducing hepato-protective autophagy, overexpressing peroxisome proliferator-activated receptor- γ (PPAR-γ), as well as attenuating hepatocyte apoptosis and increasing insulin sensitivity. Exercise training also suppresses ROS overproduction and OS in NAFLD via up-regulation of several antioxidant enzymes and anti-inflammatory mediators. Therefore, an understanding of these molecules and signalling pathways gives us valuable information about NAFLD progression and a method for developing a suitable clinical treatment. This review aimed to evaluate sources of ROS and OS in NAFLD and the molecular mechanisms involved in the beneficial effects of exercises on NAFLD.
非酒精性脂肪性肝病 (NAFLD) 是一种常见的慢性肝脏疾病,其特征是肝脏脂肪堆积。它会引起多种病理效应,如非酒精性脂肪性肝炎 (NASH) 和肝硬化、胰岛素抵抗、肥胖、高血压、血脂异常、糖尿病和心血管疾病。导致 NAFLD 发生和发展的分子机制尚未完全阐明。活性氧 (ROS) 引起的氧化应激 (OS) 和炎症可能是导致肝实质细胞死亡和组织损伤的重要机制。线粒体异常、几种抗氧化酶下调、谷胱甘肽 (GSH) 耗竭和 GSH 依赖性抗氧化剂活性降低、白细胞积聚和肝炎症是 NAFLD 中 ROS 过度产生的主要来源。ROS 的过度产生抑制了 NAFLD 中其他抗氧化防御系统的能力,并导致进一步的氧化损伤。规律运动被认为是治疗 NAFLD 的有效策略。它通过减少肝内脂肪含量、增加脂肪酸的 β-氧化、诱导肝保护自噬、过表达过氧化物酶体增殖物激活受体-γ (PPAR-γ)、以及抑制肝细胞凋亡和增加胰岛素敏感性来改善 NAFLD。运动训练还通过上调几种抗氧化酶和抗炎介质来抑制 NAFLD 中 ROS 的过度产生和 OS。因此,了解这些分子和信号通路为我们提供了有关 NAFLD 进展的有价值信息,并为开发合适的临床治疗方法提供了依据。本综述旨在评估 NAFLD 中 ROS 和 OS 的来源,以及运动对 NAFLD 的有益作用所涉及的分子机制。
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