Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China; Department of Digestive Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
Biomed Pharmacother. 2022 Sep;153:113331. doi: 10.1016/j.biopha.2022.113331. Epub 2022 Jun 29.
As the predominant type of chronic liver disease, the growing prevalence of nonalcoholic fatty liver disease (NAFLD) has become a concern worldwide. Although obesity plays the most pivotal role in NAFLD, approximately 10-20% of individuals with NAFLD who are not overweight or obese (BMI < 25 kg/m2, or BMI < 23 kg/m2 in Asians) have "lean NAFLD." Lean individuals with NAFLD have a lower prevalence of diabetes, hypertension, hypertriglyceridemia, central obesity, and metabolic syndrome than nonlean individuals with NAFLD, but higher fibrosis scores and rates of cardiovascular morbidity and all-cause mortality in advanced stages. The pathophysiological mechanisms of lean NAFLD remain poorly understood. Studies have shown that lean NAFLD is more correlated with factors such as environmental, genetic susceptibility, and epigenetic regulation. This review will examine the way in which the research progress and characteristic of lean NAFLD, and explore the function of epigenetic modification to provide the basis for the clinical treatment and diagnosis of lean NAFLD.
作为最主要的慢性肝病类型，非酒精性脂肪性肝病（NAFLD）的患病率不断增加，已成为全球关注的问题。尽管肥胖在 NAFLD 中起着最重要的作用，但大约 10-20%的非超重或肥胖（BMI<25kg/m2，或亚洲人 BMI<23kg/m2）的 NAFLD 患者为“瘦型 NAFLD”。与非瘦型 NAFLD 患者相比，瘦型 NAFLD 患者的糖尿病、高血压、高三酰甘油血症、中心性肥胖和代谢综合征的患病率较低，但在晚期纤维化评分和心血管发病率及全因死亡率较高。瘦型 NAFLD 的病理生理机制仍知之甚少。研究表明，瘦型 NAFLD 与环境、遗传易感性和表观遗传调控等因素的相关性更强。本综述将探讨瘦型 NAFLD 的研究进展和特点，并探讨表观遗传修饰的作用，为瘦型 NAFLD 的临床治疗和诊断提供依据。
