Li Xiaoxiao, Li Meng
Institute of Digestive Diseases, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
Pharmaceuticals (Basel). 2024 Aug 15;17(8):1073. doi: 10.3390/ph17081073.
Metabolic-associated steatotic liver disease (MASLD), the hepatic manifestation of metabolic syndrome, represents a growing global health concern. The intricate pathogenesis of MASLD, driven by genetic, metabolic, epigenetic, and environmental factors, leads to considerable clinical variability. Dysregulation of hepatic lipid metabolism, particularly cholesterol homeostasis, is a critical factor in the progression of MASLD and its more severe form, metabolic dysfunction-associated steatohepatitis (MASH). This review elucidates the multifaceted roles of cholesterol metabolism in MASLD, focusing on its absorption, transportation, biosynthesis, efflux, and conversion. We highlight recent advancements in understanding these processes and explore the therapeutic potential of natural products such as curcumin, berberine, and resveratrol in modulating cholesterol metabolism. By targeting key molecular pathways, these natural products offer promising strategies for MASLD management. Finally, this review also covers the clinical studies of natural products in MASLD, providing new insights for future research and clinical applications.
代谢相关脂肪性肝病（MASLD）是代谢综合征的肝脏表现，是一个日益引起全球健康关注的问题。MASLD复杂的发病机制由遗传、代谢、表观遗传和环境因素驱动，导致了相当大的临床变异性。肝脏脂质代谢失调，尤其是胆固醇稳态失调，是MASLD及其更严重形式——代谢功能障碍相关脂肪性肝炎（MASH）进展的关键因素。本综述阐明了胆固醇代谢在MASLD中的多方面作用，重点关注其吸收、运输、生物合成、流出和转化。我们强调了在理解这些过程方面的最新进展，并探讨了姜黄素、小檗碱和白藜芦醇等天然产物在调节胆固醇代谢方面的治疗潜力。通过靶向关键分子途径，这些天然产物为MASLD的管理提供了有前景的策略。最后，本综述还涵盖了天然产物在MASLD中的临床研究，为未来的研究和临床应用提供了新的见解。
