与代谢功能障碍相关的肥胖性肝病与糖尿病复杂化:病理生理学和新兴疗法
Hisanori Goto1,2, Toshinari Takamura1
1Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
Journal of obesity & metabolic syndrome
|June 19, 2025
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 与糖尿病有关,高血糖症恶化肝损伤. 抗糖尿病药物在治疗MASLD和与代谢功能障碍相关的脂肪肝炎 (MASH) 中表现有前途.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
背景情况:
- 代谢功能障碍相关的脂肪性肝病 (MASLD) 是糖尿病的肝脏表现,通常与肥胖和胰岛素抵抗有关.
- 高血糖症加剧了MASLD向代谢功能障碍相关的脂肪肝炎 (MASH) 的进展,并观察到双向关系.
- 器官间的交叉交互,涉及肝激素和骨肌肉的胰岛素抵抗,在MASLD和糖尿病进展中发挥作用.
研究的目的:
- 探索MASLD和糖尿病之间的复杂关系,重点关注高血糖的影响.
- 调查器官间交叉声在MASLD和MASH病变发生过程中的作用.
- 审查MASLD/MASH的当前和新兴治疗策略,特别是在糖尿病患者中.
主要方法:
- 关于MASLD,糖尿病及其相互联系的最新研究的综述.
- 从人类MASH和动物模型中分析转录组数据.
- 检查MASH治疗中抗糖尿病药物的临床试验数据.
主要成果:
- 高血糖和自由脂肪酸的流入促进肝脏脂肪生成和氧化应激在糖尿病患者.
- 转录组分析显示,糖尿病MASH患者的肝脏内皮细胞受损.
- 抗糖尿病药物,包括GLP-1激动剂和SGLT2抑制剂,在MASH中表现出有效性.
结论:
- MASLD和糖尿病共享一种复杂的,双向的关系,受高血糖和器官间交叉声波的影响.
- 抗糖尿病药物正在成为糖尿病患者管理MASH的关键治疗选择.
- 针对特定人群的方法对于理解MASLD/MASH病原体和开发定制治疗至关重要.
相关概念视频
01:20Pathophysiology of Diabetes
1.2K
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
1.2K
01:15Diabetes: Management and Pharmacotherapy
410
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
410
01:24Overview of Lipid Metabolism
2.6K
Lipid metabolism is a crucial process in the human body that involves the synthesis and degradation of lipids. This process is essential for energy production, cell membrane formation, and hormone production, among other functions.
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...
2.6K
01:30Liver Physiology
1.3K
The liver, an essential organ in the human body, performs over 200 vital functions that can be broadly categorized into metabolic, hematological, endocrine regulation, and bile production.
Metabolic Regulation:
The liver is the central organ involved in regulating blood composition. It stabilizes blood glucose levels, maintaining them within the range of 70–110 mg/dL. When these levels drop, the liver breaks down glycogen reserves and releases glucose into the bloodstream. It can...
Metabolic Regulation:
The liver is the central organ involved in regulating blood composition. It stabilizes blood glucose levels, maintaining them within the range of 70–110 mg/dL. When these levels drop, the liver breaks down glycogen reserves and releases glucose into the bloodstream. It can...
1.3K
01:36Carbohydrate Metabolism
11.8K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
11.8K
01:15Diabetes: Symptoms, Diagnosis, and Complications
709
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
709