Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia, USA.
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Emory University, Atlanta, Georgia, USA.
Hepatol Commun. 2023 Nov 6;7(11). doi: 10.1097/HC9.0000000000000297. eCollection 2023 Nov 1.
NAFLD, or metabolic dysfunction-associated steatotic liver disease, has increased in prevalence hand in hand with the rise in obesity and increased free sugars in the food supply. The causes of NAFLD are genetic in origin combined with environmental drivers of the disease phenotype. Dietary intake of added sugars has been shown to have a major role in the phenotypic onset and progression of the disease. Simple sugars are key drivers of steatosis, likely through fueling de novo lipogenesis, the conversion of excess carbohydrates into fatty acids, but also appear to upregulate lipogenic metabolism and trigger hyperinsulinemia, another driver. NAFLD carries a clinical burden as it is associated with obesity, type 2 diabetes, metabolic syndrome, and cardiovascular disease. Patient quality of life is also impacted, and there is an enormous economic burden due to healthcare use, which is likely to increase in the coming years. This review aims to discuss the role of dietary sugar in NAFLD pathogenesis, the health and economic burden, and the promising potential of sugar reduction to improve health outcomes for patients with this chronic liver disease.
非酒精性脂肪性肝病（NAFLD），或代谢相关脂肪性肝病，随着肥胖和食物供应中游离糖的增加，其患病率也在不断上升。NAFLD 的病因源于遗传，再加上疾病表型的环境驱动因素。饮食中添加糖的摄入已被证明在疾病表型的发生和进展中起着重要作用。简单糖是脂肪变性的主要驱动因素，可能通过为从头脂肪生成提供燃料，即将多余的碳水化合物转化为脂肪酸，但也似乎上调脂肪生成代谢并引发高胰岛素血症，这是另一个驱动因素。NAFLD 带来了临床负担，因为它与肥胖、2 型糖尿病、代谢综合征和心血管疾病有关。患者的生活质量也受到影响，由于医疗保健的使用，存在巨大的经济负担，而且这种负担可能会在未来几年增加。本综述旨在讨论饮食糖在 NAFLD 发病机制、健康和经济负担中的作用，以及减少糖摄入改善慢性肝病患者健康结果的巨大潜力。
