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代谢功能障碍相关脂肪性肝病:最新进展

METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: UPDATE.

作者信息

Dezan Maria Gabriela Fernandes, Oliveira Claudia Pinto, Cotrim Helma Pinchemel

机构信息

Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Gastro-Hepatologia, Salvador, BA, Brasil.

Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.

出版信息

Arq Gastroenterol. 2025 Sep 5;62:e24117. doi: 10.1590/S0004-2803.24612025-117. eCollection 2025.

Abstract

BACKGROUND

Since Ludwig proposed the term "nonalcoholic steatohepatitis" (NASH) for this liver disease in 1980, there have been many advances in understanding it, including its epidemiology, pathogenesis, diagnostic methods, and treatment.

OBJECTIVE

This literature review aims to discuss the most relevant aspects of metabolic dysfunction-associated steatotic liver disease (MASLD).

METHODS

The review included clinical studies from the following databases: Embase, PubMed, Scopus, Web of Science, Lilacs, Ovid, and Scopus.

RESULTS

MASLD is the most frequent liver disease worldwide, with increasing prevalence and incidence, and can evolve with liver cirrhosis and hepatocellular carcinoma. The diagnosis involves specific diagnostic criteria involving the presence of hepatic steatosis and other metabolic factors. Drug treatment, still in its incipient, involves pioglitazone, glucagon-like peptide-1 (GLP1) agonists, and sodium glucose cotransporter-2 (SGLT2) inhibitors, especially in diabetic patients. More recently, the Food and Drug Administration (FDA) approved Resmetiron for selected cases.

CONCLUSION

MASLD is extremely common, presents complex pathophysiology, and requires an intensive multidisciplinary approach. It is hoped that future studies will provide effective and accessible pharmacological therapeutic options for the disease. It is necessary to bring the population's attention to this condition, which can be associated with significant morbidity and mortality.

摘要

背景

自1980年路德维希提出“非酒精性脂肪性肝炎”(NASH)这一术语用于描述这种肝脏疾病以来,在对其的理解方面取得了许多进展,包括其流行病学、发病机制、诊断方法和治疗。

目的

本文献综述旨在讨论代谢功能障碍相关脂肪性肝病(MASLD)的最相关方面。

方法

该综述纳入了来自以下数据库的临床研究:Embase、PubMed、Scopus、科学网、Lilacs、Ovid和Scopus。

结果

MASLD是全球最常见的肝脏疾病,其患病率和发病率不断上升,并且可能发展为肝硬化和肝细胞癌。诊断涉及特定的诊断标准,包括肝脂肪变性和其他代谢因素的存在。药物治疗仍处于初期阶段,涉及吡格列酮、胰高血糖素样肽-1(GLP1)激动剂和钠-葡萄糖协同转运蛋白-2(SGLT2)抑制剂,尤其是在糖尿病患者中。最近,美国食品药品监督管理局(FDA)批准了Resmetiron用于特定病例。

结论

MASLD极为常见,具有复杂的病理生理学,需要多学科的强化方法。希望未来的研究能为该疾病提供有效且可及的药物治疗选择。有必要引起公众对这种疾病的关注,因为它可能与显著的发病率和死亡率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/061d/12435743/534433cad619/1678-4219-ag-62-e24117-gf1.jpg

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