非酒精性脂肪性肝病患者代谢紊乱发病率增高.pdfVIP

胃肠病学2007年第12卷第 12期 非酒精性脂肪性肝病患者代谢紊乱发病率增高 范建高 钟 妍 上海交通大学附属第一人民医院脂肪肝诊治中心(200080) 摘要 非酒精性脂肪性肝病(NAFLD)和代谢综合征(MetS)通常并存，胰岛素抵抗(IR)为其共同发病机制。 NAFLD患者死亡率高于对照人群，死因主要为心血管疾病和肝病。NAFLD独立于肥胖和MetS的其他组分．与MetS 和2型糖尿病发病率增高相关，提示NAFLD为MetS和糖尿病的早期病变，发病机制涉及脂肪肝诱发和加剧IR、系 统性炎症、氧应激、低脂联素血症。应常规评估并动态监测NAFLD患者代谢紊乱相关指标，治疗NAFLD应兼顾肝病 和潜在的代谢和心血管并发症。 关键词 非酒精性脂肪性肝病； 代谢综合征X； 胰岛素抗药性； 糖尿病，2型； 丙氨酸转氨酶； _y．谷氨酰转移酶 Nonalcoholic Fatty Liver Disease with hIcrea Inciderice of Metabolic Disorders FA N Jio~goo． ZHONG Yan． Centerfor Fatty Liver￡ e∞e．Shanghai Jiaotong Unwe~ity Affiliated First People’S Hospital,Shanghai(2ooo80) Abstract Nonalcoholic fatty liver disease(NAFLD)and metabolic syndrome(MetS)frequently coexist，and insulin resistance is the common pathogenic factor． Mortality rate of patients with NAFLD is significantly higher than that of the general population，and is usually due to cardiovascular and liver diseases．Recent studies have shown that NAFLD，which iS associated with an increased incidence of MetS and type 2 diabetes． iS independent of obesity and other components of MetS．Thus， NAFLD may be an early lesion of MetS and type 2 diabetes． The pathogenesis involves the fatty liver that induces or increases insulin resistance， systemic inflammation， oxidative stress， and hypoadiponectinemia． In clinical practice，it iS mandatory to evaluate and monitor dynamically the related metabolic disorder markers in NAFLD patients． The treatment of NAFLD should consider not only the relevant liver diseases， but also the potential underlying metabolic and cardiovascular complications． Key words Nonalcoholic Fatty Liver Disease； Metabolic Syndrome X： Insulin Resistance； Diabetes Mellitus，Type 2； Alanine Transaminase； gamma—Glutamyhransferase 非酒精性脂肪性肝病(NAFLD)为发达国家和 一 、 NAFLD患者代谢