Sun Zhonghan, Zheng Yan
State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
Nat Rev Gastroenterol Hepatol. 2025 Apr 8. doi: 10.1038/s41575-025-01058-8.
East Asian populations, which account for approximately 20% of the global population, have become central to the worldwide rise of metabolic diseases over the past few decades. The prevalence of metabolic disorders, including type 2 diabetes mellitus, hypertension and metabolic dysfunction-associated steatotic liver disease, has escalated sharply, contributing to a substantial burden of complications such as cardiovascular disease, chronic kidney disease, cancer and increased mortality. This concerning trend is primarily driven by a combination of genetic predisposition, unique fat distribution patterns and rapidly changing lifestyle factors, including urbanization and the adoption of Westernized dietary habits. Current advances in genomics, proteomics, metabolomics and microbiome research have provided new insights into the biological mechanisms that might contribute to the heightened susceptibility of East Asian populations to metabolic diseases. This Review synthesizes epidemiological data, risk factors and biomarkers to provide an overview of how metabolic diseases are reshaping public health in East Asia and offers insights into biological and societal drivers to guide effective, region-specific strategies.
东亚人口约占全球人口的20%，在过去几十年里，已成为全球代谢性疾病发病率上升的核心因素。包括2型糖尿病、高血压和代谢功能障碍相关脂肪性肝病在内的代谢紊乱患病率急剧上升，导致心血管疾病、慢性肾脏病、癌症等并发症负担沉重，并增加了死亡率。这一令人担忧的趋势主要是由遗传易感性、独特的脂肪分布模式以及包括城市化和采用西化饮食习惯在内的快速变化的生活方式因素共同驱动的。基因组学、蛋白质组学、代谢组学和微生物组研究的最新进展，为可能导致东亚人群对代谢性疾病易感性增加的生物学机制提供了新的见解。本综述综合了流行病学数据、风险因素和生物标志物，概述了代谢性疾病如何重塑东亚地区的公共卫生，并深入探讨了生物学和社会驱动因素，以指导有效的、针对该地区的策略。
