与代谢功能障碍相关的脂肪性肝病 (MASLD):定义,诊断,自然史和治疗
Nobuharu Tamaki1, Takefumi Kimura2, Shun-Ichi Wakabayashi2
1Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, 1-26-1 Kyonan-Cho, Tokyo, Musashino-Shi, 180-8610, Japan.
Japanese journal of radiology
|January 27, 2026
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 在临床上与非酒精性脂肪性肝病 (NAFLD) 类似. MASLD带来更高的心血管风险,而与酒精有关的肝病 (ALD) 带来更大的肝病风险,需要量身定制的监测.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 代谢疾病 代谢疾病
- 心血管健康 心血管健康
背景情况:
- 非酒精性脂肪性肝病 (NAFLD) 是慢性肝病的主要原因之一.
- 最近的重新分类将脂肪性肝病 (SLD) 定义为代谢功能障碍相关的SLD (MASLD),MetALD和酒精相关的肝病 (ALD) 基于酒精摄入量.
- 在临床上,MASLD与NAFLD相似,一致率为96-99%.
研究的目的:
- 为了比较MASLD,MetALD和ALD之间与肝脏相关的和心血管事件的风险.
- 调查与超重MASLD相比,与瘦肉MASLD相关的独特风险.
- 强调对SLD亚型的表型特异性监测策略的需要.
主要方法:
- 在定义的SLD类别 (MASLD,MetALD,ALD) 中进行比较风险分析.
- 在MASLD (瘦身与超重) 内的表型比较.
- 对MASLD目前和潜在的药物治疗方法的审查.
主要成果:
- 与肝脏相关事件的ALD风险最高,其次是MetALD和MASLD.
- MASLD携带心血管事件的最高风险,其次是MetALD和ALD.
- 瘦身MASLD显示较低的心血管风险,但比超重MASLD更高的肝脏事件风险.
- 所有SLD亚型都会增加肝外恶性瘤的风险.
结论:
- 在MASLD,MetALD和ALD之间,并发症风险差异很大,需要量身定制的监测.
- 新兴的药物疗法,如GLP-1RA和SGLT-2抑制剂,对MASLD治疗具有前景.
- 在MASLD患者的并发性脂质失调症中,他类药物和pemafibrate是有益的.
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