铁过负荷与非酒精性脂肪性肝病

当机体出现铁过负荷时 ,肝脏是首先受到损害并且损害最严重的靶器官。铁过负荷在非酒精性脂肪性肝病 (NAFLD)中的作用尚不十分明确。目前认为 ,铁过负荷是NAFLD疾病进展的一个辅助因素 ,其中HFE基因起重要作用 ,该过程可能由胰岛素抵抗所激发 ,免疫机制也可能参与其中。     

锌alpha2糖蛋白与非酒精性脂肪性肝病

随着肥胖与代谢综合征在全球的流行,非酒精性脂肪性肝病（non-alcoholic fatty liver disease, NAFLD）已成为严重威胁人类健康的公共卫生问题。脂肪在肝脏过度蓄积是NAFLD的主要特点。了解调节肝脏三酰甘油（triglyceride, TG）合成所涉及的过程是预防和治疗NAFLD新视角。锌alpha2糖蛋白(Zinc alpha2 glycoprotein, ZAG)是一种能强烈促进脂肪分解、减少脂肪蓄积的新型脂肪细胞因子。ZAG可能在维持肝脏脂质代谢平衡中发挥重要作用。     

肝脏固有免疫在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病发病机制尚未完全阐明,近年来研究表明肝脏固有免疫参与了非酒精性脂肪性肝病从单纯性脂肪肝进展至肝硬化的过程。肝脏通过固有免疫细胞的激活促进炎症介质的表达及肝细胞的凋亡参与非酒精性脂肪性肝病的病程进展。     

肝脏固有免疫在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病发病机制尚未完全阐明,近年来研究表明肝脏固有免疫参与了非酒精性脂肪件肝病从单纯性脂肪肝进展至肝硬化的过程.肝脏通过固有免疫细胞的激活促进炎症介质的表达及肝细胞的凋亡参与非酒精性脂肪性肝病的病程进展.     

肝脏固有免疫在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病发病机制尚未完全阐明,近年来研究表明肝脏固有免疫参与了非酒精性脂肪件肝病从单纯性脂肪肝进展至肝硬化的过程.肝脏通过固有免疫细胞的激活促进炎症介质的表达及肝细胞的凋亡参与非酒精性脂肪性肝病的病程进展.     

肝脏固有免疫在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病发病机制尚未完全阐明,近年来研究表明肝脏固有免疫参与了非酒精性脂肪件肝病从单纯性脂肪肝进展至肝硬化的过程.肝脏通过固有免疫细胞的激活促进炎症介质的表达及肝细胞的凋亡参与非酒精性脂肪性肝病的病程进展.     

肝脏固有免疫在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病发病机制尚未完全阐明,近年来研究表明肝脏固有免疫参与了非酒精性脂肪件肝病从单纯性脂肪肝进展至肝硬化的过程.肝脏通过固有免疫细胞的激活促进炎症介质的表达及肝细胞的凋亡参与非酒精性脂肪性肝病的病程进展.     

肝脏固有免疫在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病发病机制尚未完全阐明,近年来研究表明肝脏固有免疫参与了非酒精性脂肪件肝病从单纯性脂肪肝进展至肝硬化的过程.肝脏通过固有免疫细胞的激活促进炎症介质的表达及肝细胞的凋亡参与非酒精性脂肪性肝病的病程进展.     

肝脏固有免疫在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病发病机制尚未完全阐明,近年来研究表明肝脏固有免疫参与了非酒精性脂肪件肝病从单纯性脂肪肝进展至肝硬化的过程.肝脏通过固有免疫细胞的激活促进炎症介质的表达及肝细胞的凋亡参与非酒精性脂肪性肝病的病程进展.     

肝脏固有免疫在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病发病机制尚未完全阐明,近年来研究表明肝脏固有免疫参与了非酒精性脂肪件肝病从单纯性脂肪肝进展至肝硬化的过程.肝脏通过固有免疫细胞的激活促进炎症介质的表达及肝细胞的凋亡参与非酒精性脂肪性肝病的病程进展.     

肠道菌群与非酒精性脂肪肝病相关性研究进展

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)发病机制尚未完全阐明,目前广为接受的是“二次打击”学说,近年来关于肠道菌群与NAFLD的研究不断深入,充实和发展了“二次打击”学说,也为NAFLD的治疗提供了新思路。本文就肠道菌群与NAFLD相关性的研究进展及益生元、益生菌治疗NAFLD进展进行综述。     

非酒精性脂肪性肝病与幽门螺杆菌感染的相关性

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)本质上是一种肝代谢性疾病,其发病机制复杂,目前尚未完全明确.目前各项资料显示幽门螺杆菌感染(Helicobacter pylori,Hp)与NAFLD的发生和发展有密切的关系,但也有研究得出了相反的结论.对于存在争议的部分至今尚未解决,但如证实Hp感染可作为NAFLD的一种独立危险因素存在,则对NAFLD发病预测以及治疗提供帮助,因此研究两者相关性的工作仍然具有临床意义.     

Predictivity of fatty liver index for non-alcoholic fatty liver disease in lean females with polycystic ovary syndrome

BackgroundFatty liver index (FLI) is a simple tool used to predict non-alcoholic fatty liver disease (NAFLD). The role of FLI in polycystic ovary syndrome (PCOS) for the prediction of NAFLD has not been elucidated.MethodsThis case-control study was from January 2014 to January 2016. Anthropometric measurements, biochemical testing, and abdominal ultrasonography were performed in 83 premenopausal otherwise healthy women with PCOS and 58 controls. NAFLD was diagnosed by ultrasound. The predictivity of FLI for NAFLD in lean and overweight/obese females with PCOS was analyzed.ResultsThe γ-glutamyl transferase levels were significantly higher in the females with PCOS than in the controls (p = 0.001). In women with PCOS, FLI was significantly higher in females with NAFLD comparing to those without NAFLD (47.1 ± 33.6 vs. 16.9 ± 21.6; p = 0.001). For the PCOS group, Body Mass Index had the strongest relationship with FLI (p < 0.05, r = 0.908). FLI < 30 was calculated for all the lean females. The lean females with PCOS had a significantly higher rate of NAFLD (27.5% vs. 8.8%; p = 0.041) than lean controls.ConclusionAn FLI < 30 was not sufficient to rule out NAFLD in the lean PCOS patients.     

Morphological and functional characterization of non-alcoholic fatty liver disease induced by a methionine-choline-deficient diet in C57BL/6 mice

Background: Non-alcoholic fatty liver disease (NAFLD), including non-alcoholic steatohepatitis (NASH), appears to be increasingly common worldwide. Its histopathology and the effects of nutrition on liver function have not been fully determined. Aim: To elucidate the cellular mechanisms of NAFLD induced by a methionine-choline-deficient (MCD) diet in mice. Particular focus was placed on the role of phagocytic cells. Methods: Male C57BL/6 mice were fed an MCD diet for 30 weeks. A recovery model was also established wherein a normal control diet was provided for 2 weeks after a period of 8, 16, or 30 weeks. Results: Mice fed the MCD diet for ≥2 weeks exhibited severe steatohepatitis with elevated serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Steatohepatitis was accompanied by the infiltration of CD68-positive macrophages (Kupffer cells). The severity of steatohepatitis increased in the first 16 weeks but was seen to lessen by week 30. Fibrosis began to develop at 10 weeks and continued thereafter. Steatohepatitis and elevated serum hepatic enzyme concentrations returned to normal levels after switching the diet back to the control within the first 16 weeks, but fibrosis and CD68-positive macrophages remained. Conclusions: The histopathological changes and irreversible fibrosis seen in this model were caused by prolonged feeding of an MCD diet. These results were accompanied by changes in the activity of CD68-positive cells with temporary elevation of CCL-2, MMP-13, and MMP-9 levels, all of which may trigger early steatohepatitis and late fibrosis through phagocytosis-associated MMP induction.     

Serum bilirubin levels are inversely associated with nonalcoholic fatty liver disease

Background/Aims

Serum bilirubin exerts antioxidant and cytoprotective effects. In addition, elevated serum bilirubin levels are associated with a decreased risk of metabolic and cardiovascular diseases. However, few studies have evaluated whether serum bilirubin is associated with non-alcoholic fatty liver disease (NAFLD), which is closely associated with other metabolic diseases. The aim of this study was thus to elucidate the association between serum total bilirubin levels and NAFLD.

Methods

A cross-sectional study of 17,348 subjects undergoing a routine health check-up was conducted. Subjects positive for hepatitis B or hepatitis C virus, or with other hepatitis history were excluded. NAFLD was diagnosed on the basis of typical ultrasonographic findings and an alcohol consumption of less than 20 g/day.

Results

The mean age of the subjects was 49 years and 9,076 (52.3%) were men. The prevalence of NAFLD decreased steadily as the serum bilirubin level increased in both men and women (P<0.001 for both). Multivariate regression analysis adjusted for other metabolic risk factors showed that serum bilirubin level was inversely associated with the prevalence of NAFLD [odds ratio (OR)=0.88, 95% confidence interval (CI)=0.80-0.97]. Furthermore, there was an inverse, dose-dependent association between NAFLD and serum total bilirubin levels (OR=0.83, 95% CI=0.75-0.93 in the third quartile; OR=0.80, 95% CI=0.71-0.90 in the fourth quartile vs. lowest quartile, P for trend <0.001).

Conclusions

Serum bilirubin levels were found to be inversely associated with the prevalence of NAFLD independent of known metabolic risk factors. Serum bilirubin might be a protective marker for NAFLD.     

替米沙坦抑制大鼠非酒精性脂肪肝纤维化

目的 探讨替米沙坦(Tel)对大鼠非酒精性脂肪肝纤维化(NAFLF)的抑制作用.方法 60只Wistar大鼠随机均分为6个组,对照组用含胆碱的氨基酸(CSAA)饲料喂养,添加0(CSAA组)或2.5 mg/(kg BW)(CDAA治疗组)的Tel;剩余4组用胆碱缺乏的氨基酸(CDAA)饲料喂养复制非酒精性脂肪肝纤维化模型,分别添加0(CDAA组)、0.5(低)、1.0(中)和2.5 mg/(kg BW)(高浓度组)的Tel,共10周.常规方法检测血清生化指标.免疫组化法观察肝组织α-平滑肌激动蛋白(α-SMA)和转化生长因子-β1(TGF-β1)的表达;实时定量PCR法测定肝组织Ⅰ型前胶原、金属基质蛋白酶(MMPs)及其抑制物(TIMPs)的表达.结果 CDAA组血浆中透明质酸,碱性磷酸酶,γ-谷氨酰转肽酶和总胆红素均高于CDAA添加Tel组(P＜0.05或P＜0.01);肝组织α-SMA和TGFβ1定量分析表明,CDAA组表达明显高于CDAA添加Tel组(均P＜0.01).CDAA组的Ⅰ型前胶原表达明显高于CDAA添加Tel组(P＜0.01),且随着Tel剂量的增加,表达逐渐减少;同时MMP-13表达上升(P＜0.01),而MMP-2及9和TIMP-1及2的表达下降(P＜0.01);Tel控制CDAA喂养大鼠的体质量增加.结论 替米沙坦可通过抑制肝星状细胞的活化而阻止NAFLF的形成,有望成为控制非酒精性脂肪肝病发展的很有前景的药物.     

The association of non-alcoholic fatty liver disease with thyroid peroxidase and thyroglobulin antibody: A new insight from SPECT-China study

Abstract

Non-alcoholic fatty liver disease (NAFLD) has been studied with inflammation and immune, but the link with thyroid autoimmunity is unreported. This study aimed to explore the direct association of NAFLD with thyroid autoimmune disease (AITD) among participants with normal thyroid stimulating hormone (TSH) levels. The data were obtained from a cross-sectional study (SPECT-China). A total of 7982 participants were enrolled. Participants underwent several checkups including peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), thyroid, and liver ultrasonography (US). The prevalence of NAFLD was higher in TPOAb and/or TgAb positive [TPO/TgAb (+)] group and TPOAb and/or TgAb together with US positive [TPO/TgAb (+) and US (+)] group for both genders. After full adjustment, binary logistic analysis showed the presence of NAFLD was positively associated with the serum level of TPOAb in men (p?<?.001) and TgAb in women (p?=?.001). Both TPO/TgAb (+) and TPO/TgAb (+) and US (+) were associated with an increased risk of NAFLD in both genders [TPO/TgAb (+): odds ratio (OR) 1.474, 95% confidence interval (CI) 1.102, 1.970 in men and OR 1.308, 95%CI 1.061, 1.612 in women; TPO/TgAb (+) and US (+): OR 1.796, 95%CI 1.143, 2.820 in men and OR 1.380, 95%CI 1.058, 1.801 in women]. Thus, we got a conclusion that the prevalence of NAFLD was positively associated with the level and the positivity of TPOAb and TgAb among participants with normal TSH levels. This is the first report suggesting that there might exist common pathways in the pathogenesis of NAFLD and thyroid autoimmunity.     

Association between APOC3 polymorphisms and non-alcoholic fatty liver disease risk: a meta-analysis

Background and AimThe apolipoprotein C3 (APOC3) polymorphism has been reported to predispose to non-alcoholic fatty liver disease (NAFLD). However, the results remain inconclusive. This meta-analysis aimed to provide insights into the association between APOC3 polymorphisms and NAFLD risk.MethodsStudies with terms “NALFD” and “APOC3” were retrieved from PubMed, Web of Science, CNKI and Wanfang databases up to August 1, 2019. Pooled odds ratio (OR) and 95% confidence interval (95% CI) for the association of APOC3 polymorphisms and NAFLD risk were calculated using fixed and random-effects models.ResultsA total of twelve studies from eleven articles were included. Of them, eight studies (1750 cases and 2181 controls) reported the strong association of variant rs2854116 with NAFLD and six studies (1523 cases and 1568 controls) found the association of rs2854117 polymorphism with NAFLD. Overall, a statistically significant association between rs2854116 polymorphism of APOC3 gene and NAFLD risk was found only under dominant model. However, association of rs2854117 polymorphism with NAFLD risk was not detected under all four genetic models. In sub-group analysis of NAFLD subjects based on country, no association among them in China was detected. Besides, four studies analyze the association between the two polymorphisms and clinical characteristics in all subjects or NAFLD patients, and we also failed detect any association between the wild carriers and variant carriers.ConclusionThe meta-analyses suggests that the rs2854116 polymorphism but not rs2854117 polymorphism in APOC3 gene might be a risk factor for NAFLD among Asians. That is, individuals with CT+CC genotype have higher risk of developing NAFLD. However, studies with sufficient sample size are needed for the further validation.     

The role of the circadian clock in the development,progression, and treatment of non-alcoholic fatty liver disease

The circadian clock comprises a cellular endogenous timing system coordinating the alignment of physiological processes with geophysical time. Disruption of circadian rhythms has been associated with several metabolic diseases. In this review, we focus on liver as a major metabolic tissue and one of the most well-studied organs with regard to circadian regulation. We summarize current knowledge about the role of local and systemic clocks and rhythms in regulating biological functions of the liver. We discuss how the disruption of circadian rhythms influences the development of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). We also critically evaluate whether NAFLD/NASH may in turn result in chronodisruption. The last chapter focuses on potential roles of the clock system in prevention and treatment of NAFLD/NASH and the interaction of current NASH drug candidates with liver circadian rhythms and clocks. It becomes increasingly clear that paying attention to circadian timing may open new avenues for the optimization of NAFLD/NASH therapies and provide interesting targets for prevention and treatment of these increasingly prevalent disorders.