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代谢相关脂肪性肝病与慢性肾脏病的相互作用:流行病学、病理生理机制与治疗策略。

Interplay between metabolic dysfunction-associated fatty liver disease and chronic kidney disease: Epidemiology, pathophysiologic mechanisms, and treatment considerations.

机构信息

Center for Nephrology "G. Papadakis," General Hospital of Nikaia-Piraeus "Agios Panteleimon," Nikaia 18454, Greece.

出版信息

World J Gastroenterol. 2022 Oct 21;28(39):5691-5706. doi: 10.3748/wjg.v28.i39.5691.


DOI:10.3748/wjg.v28.i39.5691
PMID:36338895
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9627426/
Abstract

The recently proposed nomenclature change from non-alcoholic fatty liver disease to metabolic dysfunction-associated fatty liver disease (MAFLD) has resulted in the reappraisal of epidemiological trends and associations with other chronic diseases. In this context, MAFLD appears to be tightly linked to incident chronic kidney disease (CKD). This association may be attributed to multiple shared risk factors including type 2 diabetes mellitus, arterial hypertension, obesity, dyslipidemia, and insulin resistance. Moreover, similarities in their molecular pathophysiologic mechanisms can be detected, since inflammation, oxidative stress, fibrosis, and gut dysbiosis are highly prevalent in these pathologic states. At the same time, lines of evidence suggest a genetic predisposition to MAFLD due to gene polymorphisms, such as the rs738409 G allele polymorphism, which may also propagate renal dysfunction. Concerning their management, available treatment considerations for obesity (bariatric surgery) and novel antidiabetic agents (glucagon-like peptide 1 receptor agonists, sodium-glucose co-transporter 2 inhibitors) appear beneficial in preclinical and clinical studies of MAFLD and CKD modeling. Moreover, alternative approaches such as melatonin supplementation, farnesoid X receptor agonists, and gut microbiota modulation may represent attractive options in the future. With a look to the future, additional adequately sized studies are required, focusing on preventing renal complications in patients with MAFLD and the appropriate management of individuals with concomitant MAFLD and CKD.

摘要

最近提出的将非酒精性脂肪性肝病的命名更改为代谢功能障碍相关脂肪性肝病(MAFLD),导致对其流行病学趋势和与其他慢性疾病的关联进行重新评估。在这种情况下,MAFLD 似乎与慢性肾脏病(CKD)的发生密切相关。这种关联可能归因于多种共同的危险因素,包括 2 型糖尿病、动脉高血压、肥胖、血脂异常和胰岛素抵抗。此外,由于炎症、氧化应激、纤维化和肠道菌群失调在这些病理状态中非常普遍,因此可以发现它们在分子病理生理机制方面存在相似之处。同时,有证据表明 MAFLD 存在遗传易感性,这是由于基因多态性引起的,例如 rs738409 G 等位基因多态性,这也可能导致肾功能障碍。在治疗方面,肥胖症(减重手术)和新型抗糖尿病药物(胰高血糖素样肽 1 受体激动剂、钠-葡萄糖共转运蛋白 2 抑制剂)的现有治疗考虑因素似乎对 MAFLD 和 CKD 模型的临床前和临床研究有益。此外,其他方法,如褪黑素补充剂、法尼醇 X 受体激动剂和肠道微生物群调节,可能在未来具有吸引力。展望未来,需要进行更多适当规模的研究,重点是预防 MAFLD 患者的肾脏并发症,以及对同时患有 MAFLD 和 CKD 的个体进行适当的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/9627426/b8e1b4a51a96/WJG-28-5691-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/9627426/b8e1b4a51a96/WJG-28-5691-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/9627426/b8e1b4a51a96/WJG-28-5691-g001.jpg

相似文献

[1]
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[4]
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[5]
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[6]
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[7]
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[8]
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引用本文的文献

[1]
Liver-Kidney Crosstalk in Major Pediatric Diseases: Unraveling the Complexities and Clinical Challenges.

J Clin Med. 2025-6-2

[2]
MAFLD: Exploring the Systemic Effects Beyond Liver.

J Community Hosp Intern Med Perspect. 2025-1-6

[3]
Altered kidney function in fatty liver disease: confronting the "MAFLD-renal syndrome".

Front Clin Diabetes Healthc. 2025-1-8

[4]
Role of metabolic dysfunction-associated steatotic liver disease and of its genetics on kidney function in childhood obesity.

Int J Obes (Lond). 2025-4

[5]
Bioactive metabolites: A clue to the link between MASLD and CKD?

Clin Mol Hepatol. 2025-1

[6]
Epicardial and liver fat implications in albuminuria: a retrospective study.

Cardiovasc Diabetol. 2024-8-22

[7]
Interplay between metabolic dysfunction-associated fatty liver disease and renal function: An intriguing pediatric perspective.

World J Gastroenterol. 2024-4-21

[8]
Cardio-renal-metabolic disease in primary care setting.

Diabetes Metab Res Rev. 2024-3

[9]
System failure: Systemic inflammation following spinal cord injury.

Eur J Immunol. 2024-1

[10]
The Impact of COVID-19 Pandemic Lockdown on the Relationship between Pediatric MAFLD and Renal Function.

J Clin Med. 2023-3-4

本文引用的文献

[1]
Prevalence of Metabolic-associated Fatty Liver Disease in Mexico and Development of a Screening Tool: The MAFLD-S Score.

Gastro Hep Adv. 2022-3-30

[2]
The impact of SGLT2 inhibitors on inflammation: A systematic review and meta-analysis of studies in rodents.

Int Immunopharmacol. 2022-10

[3]
Kidney outcomes associated with sodium-glucose cotransporter 2 inhibitors versus glucagon-like peptide 1 receptor agonists: A real-world population-based analysis.

EClinicalMedicine. 2022-6-25

[4]
The Role of Melatonin in Chronic Kidney Disease and Its Associated Risk Factors: A New Tool in Our Arsenal?

Am J Nephrol. 2022

[5]
Melatonin Alleviates PM-Induced Hepatic Steatosis and Metabolic-Associated Fatty Liver Disease in ApoE Mice.

Oxid Med Cell Longev. 2022

[6]
Impact of semaglutide on biochemical and radiologic measures of metabolic-dysfunction associated fatty liver disease across the spectrum of glycaemia: A meta-analysis.

Diabetes Metab Syndr. 2022-6

[7]
The Benefit of Bariatric Surgery on Histological Features of Metabolic Associated Fatty Liver Disease Assessed Through Noninvasive Methods.

Obes Surg. 2022-8

[8]
Probiotic Therapy With VSL#3 in Patients With NAFLD: A Randomized Clinical Trial.

Front Nutr. 2022-5-24

[9]
Effect of Probiotics on Liver Enzymes in Patients With Non-alcoholic Fatty Liver Disease: An Umbrella of Systematic Review and Meta-Analysis.

Front Nutr. 2022-5-23

[10]
Melatonin Suppresses NLRP3 Inflammasome Activation via TLR4/NF-κB and P2X7R Signaling in High-Fat Diet-Induced Murine NASH Model.

J Inflamm Res. 2022-5-31

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