Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via S. Pansini 5, 80131 Naples, Italy.
Department of Medicine and Surgery, University of Salerno, Via Allende, 84081 Baronissi, Italy.
Nutrients. 2021 May 15;13(5):1679. doi: 10.3390/nu13051679.
Metabolic- (dysfunction) associated fatty liver disease (MAFLD) represents the predominant hepatopathy and one of the most important systemic, metabolic-related disorders all over the world associated with severe medical and socio-economic repercussions due to its growing prevalence, clinical course (steatohepatitis and/or hepatocellular-carcinoma), and related extra-hepatic comorbidities. To date, no specific medications for the treatment of this condition exist, and the most valid recommendation for patients remains lifestyle change. MAFLD has been associated with metabolic syndrome; its development and progression are widely influenced by the interplay between genetic, environmental, and nutritional factors. Nutrigenetics and nutrigenomics findings suggest nutrition's capability, by acting on the individual genetic background and modifying the specific epigenetic expression as well, to influence patients' clinical outcome. Besides, immunity response is emerging as pivotal in this multifactorial scenario, suggesting the interaction between diet, genetics, and immunity as another tangled network that needs to be explored. The present review describes the genetic background contribution to MAFLD onset and worsening, its possibility to be influenced by nutritional habits, and the interplay between nutrients and immunity as one of the most promising research fields of the future in this context.
代谢相关脂肪性肝病(MAFLD)是一种主要的肝疾病,也是全球最重要的与代谢相关的系统性疾病之一,由于其患病率不断增加、临床病程(脂肪性肝炎和/或肝细胞癌)以及相关的肝外合并症,对患者造成了严重的医疗和社会经济影响。迄今为止,尚无针对该疾病的特效治疗药物,对患者最有效的建议仍然是生活方式的改变。MAFLD 与代谢综合征有关;其发生和发展受到遗传、环境和营养因素相互作用的广泛影响。营养遗传学和营养基因组学的研究结果表明,营养可以通过作用于个体遗传背景并改变特定的表观遗传表达,从而影响患者的临床结局。此外,免疫反应在这种多因素情况下也显得至关重要,提示饮食、遗传和免疫之间的相互作用是另一个需要探索的复杂网络。本文综述了遗传背景对 MAFLD 发病和恶化的影响,其受营养习惯影响的可能性,以及营养与免疫之间的相互作用,这是该领域未来最有前途的研究领域之一。