Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China.
Department of Cardiology, Huanggang Central Hospital, HuBei Province, China; Huanggang Institute of Translational Medicine, Huanggang, China.
Atherosclerosis. 2022 Aug;355:30-44. doi: 10.1016/j.atherosclerosis.2022.07.010. Epub 2022 Jul 19.
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide. Increasing evidence suggests that, in addition to traditional metabolic risk factors such as obesity, hypercholesterolemia, hypertension, diabetes mellitus, and insulin resistance (IR), nonalcoholic fatty liver disease (NAFLD) is an emerging driver of ASCVD via multiple mechanisms, mainly by disrupting lipid metabolism. The lack of pharmaceutical treatment has spurred substantial investment in the research and development of NAFLD drugs. However, many reagents with promising therapeutic potential for NAFLD also have considerable impacts on the circulating lipid profile. In this review, we first summarize the mechanisms linking lipid dysregulation in NAFLD to the progression of ASCVD. Importantly, we highlight the potential risks of/benefits to ASCVD conferred by NAFLD pharmaceutical treatments and discuss potential strategies and next-generation drugs for treating NAFLD without the unwanted side effects.
动脉粥样硬化性心血管疾病(ASCVD)仍然是全球范围内的主要死亡原因。越来越多的证据表明,除了肥胖、高胆固醇血症、高血压、糖尿病和胰岛素抵抗(IR)等传统代谢危险因素外,非酒精性脂肪性肝病(NAFLD)也是 ASCVD 的一个新的驱动因素,主要通过多种机制,主要是通过破坏脂质代谢。由于缺乏药物治疗,人们对 NAFLD 药物的研发投入了大量资金。然而,许多具有治疗 NAFLD 潜力的试剂也对循环脂质谱有相当大的影响。在这篇综述中,我们首先总结了将 NAFLD 中的脂质失调与 ASCVD 进展联系起来的机制。重要的是,我们强调了 NAFLD 药物治疗对 ASCVD 带来的潜在风险/益处,并讨论了在没有不良副作用的情况下治疗 NAFLD 的潜在策略和下一代药物。