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非酒精性脂肪性肝病与动脉粥样硬化:同一代谢紊乱之两面?

NAFLD and Atherosclerosis: Two Sides of the Same Dysmetabolic Coin?

机构信息

Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

出版信息

Trends Endocrinol Metab. 2019 Dec;30(12):891-902. doi: 10.1016/j.tem.2019.08.008. Epub 2019 Oct 17.

Abstract

The prevalence of non-alcoholic fatty liver disease (NAFLD) is strongly increasing and may put patients at increased risk for atherosclerotic cardiovascular disease (asCVD). Both disease phenotypes often co-occur, in the case of obesity, insulin resistance, diabetes mellitus type 2, and the metabolic syndrome. We explore the pathogenesis of NAFLD, the epidemiology of asCVD in NAFLD patients, shared drivers of both phenotypes, and factors caused by NAFLD that contribute to asCVD. Genetic studies support that NAFLD may drive asCVD through mixed hyperlipidemia. Next, we discuss the prospects of lifestyle improvement and pharmacological treatment of NAFLD for asCVD risk reduction. Finally, we point out that earlier identification of patients with NAFLD should be pursued by increasing awareness of the association of these two phenotypes and collaboration between the involved physicians.

摘要

非酒精性脂肪性肝病(NAFLD)的患病率正在大幅上升,可能使患者罹患动脉粥样硬化性心血管疾病(asCVD)的风险增加。在肥胖、胰岛素抵抗、2 型糖尿病和代谢综合征的情况下,这两种疾病表型经常同时出现。我们探讨了 NAFLD 的发病机制、NAFLD 患者 asCVD 的流行病学、两种表型的共同驱动因素以及 NAFLD 导致 asCVD 的因素。遗传研究支持 NAFLD 可能通过混合性高脂血症导致 asCVD。接下来,我们讨论改善生活方式和药物治疗 NAFLD 以降低 asCVD 风险的前景。最后,我们指出,应该通过提高对这两种表型关联的认识以及相关医生之间的合作,来更早地识别出患有 NAFLD 的患者。

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