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非酒精性脂肪性肝病的临床见解及黄酮类化合物的治疗潜力:最新进展

Clinical Insights into Non-Alcoholic Fatty Liver Disease and the Therapeutic Potential of Flavonoids: An Update.

作者信息

Kozłowska Aleksandra

机构信息

Department of Social Medicine and Public Health, Medical University of Warsaw, 02-106 Warsaw, Poland.

出版信息

Nutrients. 2025 Mar 9;17(6):956. doi: 10.3390/nu17060956.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is considered a significant global health issue related to serious metabolic disorders. However, effective pharmacological treatments are still limited. Flavonoids, a wide group of polyphenol substances, exert anti-inflammatory and lipid-lowering effects in preclinical data. Thus, implementing these research findings in clinical practice could significantly help manage NAFLD and its consequences. This narrative review assesses the therapeutic potential of flavonoids in managing NAFLD. The research collected randomized controlled trials (RCTs) and meta-analyses of RCTs from the past five years concerning the impact of flavonoids on NAFLD. A total of 20 studies were selected according to predetermined inclusion criteria, comprising thirteen randomized controlled trials (RCTs) and seven meta-analyses. The research underscores the beneficial effects of flavonoids in the management of NAFLD through the enhancement of lipid metabolism, the reduction in hepatic steatosis, and the provision of anti-inflammatory actions. Clinical trials demonstrate that interventions rich in flavonoids, including quercetin, epigallocatechin gallate, naringenin, and isoflavones, substantially reduce liver fat content and enhance liver enzyme profiles, with certain compounds exhibiting superior efficacy in particular subgroups, such as older adults and females. Nonetheless, whereas these therapies significantly diminish hepatic steatosis, their effect on fibrosis is constrained. To sum up, flavonoids exhibit significant potential as supplementary treatments for NAFLD by enhancing liver function, lipid metabolism, and inflammation. Additional extensive controlled clinical trials are necessary to create uniform treatment methods and ascertain their long-term therapeutic advantages.

摘要

非酒精性脂肪性肝病(NAFLD)被认为是一个与严重代谢紊乱相关的重大全球健康问题。然而,有效的药物治疗仍然有限。黄酮类化合物是一大类多酚物质,临床前数据显示其具有抗炎和降脂作用。因此,将这些研究结果应用于临床实践可以显著有助于管理NAFLD及其后果。本叙述性综述评估了黄酮类化合物在管理NAFLD方面的治疗潜力。该研究收集了过去五年中关于黄酮类化合物对NAFLD影响的随机对照试验(RCT)和RCT的荟萃分析。根据预先确定的纳入标准共选择了20项研究,包括13项随机对照试验(RCT)和7项荟萃分析。该研究强调了黄酮类化合物通过增强脂质代谢、减少肝脏脂肪变性和提供抗炎作用,在管理NAFLD方面的有益效果。临床试验表明,富含黄酮类化合物的干预措施,包括槲皮素、表没食子儿茶素没食子酸酯、柚皮素和异黄酮,可显著降低肝脏脂肪含量并改善肝功能指标,某些化合物在特定亚组(如老年人和女性)中表现出更好的疗效。尽管如此,虽然这些疗法能显著减轻肝脏脂肪变性,但其对纤维化的作用有限。总之,黄酮类化合物通过增强肝功能、脂质代谢和炎症,作为NAFLD的辅助治疗具有显著潜力。还需要更多广泛的对照临床试验来制定统一的治疗方法并确定其长期治疗优势。

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