与代谢功能障碍相关的脂肪性肝病:异质的病理机制和基于代谢的治疗疗法的有效性
Norbert Stefan1, Hannele Yki-Järvinen2, Brent A Neuschwander-Tetri3
1Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany.
The lancet. Diabetes & endocrinology
|December 16, 2024
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 是一个日益严重的全球健康问题. 了解MASLD的理解
科学领域:
- 肝病学和代谢疾病
- 心血管健康 心血管健康
- 肝病病理生理学 肝病病理生理学
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 是一个快速增长的全球健康问题.
- MASLD与严重的结局有关,包括肝硬化,肝癌,2型糖尿病,心血管疾病和慢性病.
- 与心脏相关的死亡率是MASLD患者死亡的主要原因,这是由于与心脏代谢疾病共享的致病机制.
研究的目的:
- 审查MASLD的异质性,涉及其发病,临床结果和对基于代谢的治疗的反应.
- 探索MASLD异质性对未来精准医学方法的影响.
- 突出肝脏健康和心脏代谢疾病进展之间的复杂相互作用.
主要方法:
- 关于MASLD病变发生,临床进展和治疗反应的综合文献综述.
- 分析共同和独特的病理生理路径,将MASLD与心脏代谢疾病联系起来.
- 评估治疗疗效和对风险因素影响异质性的证据.
主要成果:
- 在MASLD病理生理学中存在显著的异质性,影响疾病进展和心脏代谢并发症.
- 减肥仍然是主要的非药物治疗,但药物治疗显示出不同的反应.
- 在治疗反应中观察到的异质性延伸到心脏代谢风险因素的变化.
结论:
- MASLD的异质性为风险预测,预防和治疗带来了挑战.
- 目前的证据不足以在MASLD中实施精准医学.
- 进一步了解MASLD异质性可能为未来的个性化治疗策略铺平道路.
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