Department of Hepatology and Gastroenterology, Campus Virchow Clinic and Campus Charité Mitte, Charité University Medicine, Berlin, Germany.
Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Obes Rev. 2023 Oct;24(10):e13612. doi: 10.1111/obr.13612. Epub 2023 Aug 8.
Non-alcoholic fatty liver disease (NAFLD) is a disorder characterized by excessive accumulation of fat in the liver that can progress to liver inflammation (non-alcoholic steatohepatitis [NASH]), liver fibrosis, and cirrhosis. Although most efforts for drug development are focusing on the treatment of the latest stages of NAFLD, where significant fibrosis and NASH are present, findings from studies suggest that the amount of liver fat may be an important independent risk factor and/or predictor of development and progression of NAFLD and metabolic diseases. In this review, we first describe the current tools available for quantification of liver fat in humans and then present the clinical and pathophysiological evidence that link liver fat with NAFLD progression as well as with cardiometabolic diseases. Finally, we discuss current pharmacological and non-pharmacological approaches to reduce liver fat and present open questions that have to be addressed in future studies.
非酒精性脂肪性肝病(NAFLD)是一种以肝脏脂肪堆积过多为特征的疾病,可进展为肝脏炎症(非酒精性脂肪性肝炎[NASH])、肝纤维化和肝硬化。虽然大多数药物开发工作都集中在治疗存在显著纤维化和 NASH 的 NAFLD 晚期阶段,但研究结果表明,肝脏脂肪含量可能是 NAFLD 发生和进展以及代谢性疾病的一个重要独立风险因素和/或预测因素。在这篇综述中,我们首先描述了目前用于人体肝脏脂肪定量的工具,然后介绍了将肝脏脂肪与 NAFLD 进展以及与心血管代谢疾病联系起来的临床和病理生理学证据。最后,我们讨论了目前减少肝脏脂肪的药理学和非药理学方法,并提出了未来研究中需要解决的开放性问题。