在MASLD中抗精神病药物的临床和分子影响
Celina Gonzalez1, Misael Uribe2, Norberto C Chavez-Tapia2
1Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Annals of hepatology
|November 17, 2025
概括
第二代抗精神病药物 (SGA) 在患有严重精神疾病 (SMI) 的患者中,有助于代谢功能障碍相关的脂肪性肝病 (MASLD). SGAs通过影响脂质代谢,线粒体健康和肠道细菌来破坏肝功能,需要定期监测肝脏.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 精神病学是一个精神病学.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD),以前称为NAFLD,在严重精神疾病 (SMI) 患者中越来越令人担忧.
- 第二代抗精神病药物 (SGA) 经常用于SMI,并与代谢障碍有关.
研究的目的:
- 调查SGA在SMI患者中MASLD病变发生中的作用.
- 突出SGA诱导肝功能障碍和脂质积累的机制.
主要方法:
- 对SGA诱导的代谢功能障碍和肝损伤的现有证据的审查.
- 分析分子机制,包括SREBP激活,线粒体功能障碍和肠道微生物群变化.
- 对精神病患者MASLD查的非侵入性生物标志物的讨论.
主要成果:
- 通过脂肪组织功能障碍,线粒体损伤和肝脏脂质代谢的改变,SGAs会导致MASLD.
- 关键机制包括SREBP激活,线粒体呼吸受损,炎症,AMPK通路变化和肠道失调.
- 像FLI和FIB-4这样的非侵入性标记物显示出早期检测和风险分层的希望.
结论:
- 在SMI中,SGA对MASLD的发展至关重要,因为它破坏了线粒体平衡,脂质代谢和肠肝轴.
- 建议将常规肝脏监测纳入精神病治疗.
- 未来的研究应该专注于SGI患者肝脏保护的预防和治疗策略.
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