白藜芦醇治疗非酒精性脂肪性肝病机制的研究进展

非酒精性脂肪性肝病（NAFLD）的发病机制主要是二次打击学说,细胞因子在二次打击过程中起着重要的作用,其中脂联素及脂联素受体的作用受到关注。白藜芦醇是目前除饮食控制和运动以外,治疗NAFLD最有希望的药物。此文通过总结白藜芦醇在治疗NAFLD时脂联素及脂联素受体的变化,阐述白藜芦醇治疗NAFLD的机制。     

非酒精性脂肪性肝病治疗进展

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是全世界最常见的慢性肝病,给社会带来严峻的经济负担。目前NAFLD的治疗包括生活方式干预、药物治疗、外科手术治疗。本文结合国内外文献对NAFLD的治疗进展进行概述。     

脂肪因子在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病(NAFLD)是一种慢性进行性肝病,其发病与肥胖、2型糖尿病密切相关。脂肪组织能产生和分泌具有促炎和抗炎特性的细胞因子,在NAFLD发病过程中起着至关重要的作用。脂联素和瘦素在NAFLD的病理生理学方面具有明确的作用,其他脂肪因子如抵抗素、内脂素、趋化素、视黄醇结合蛋白4、丝氨酸蛋白酶抑制剂、Apelin等在NAFLD发病机制和进展中的作用需要进一步研究。此外,用于治疗NAFLD的药物如噻唑烷二酮类、他汀类药物等对脂肪因子水平产生有利影响,可能有助于改善肝功能。该文对脂肪因子与NAFLD之间的关系作一综述,并讨论脂肪因子作为NAFLD潜在治疗靶点的意义。     

非酒精性脂肪性肝病的治疗进展

非酒精性脂肪性肝病(NAFLD)已成为世界第一大肝病,患病率在持续上升,且作为代谢综合征的组分成为多种严重心脑血管疾病的危险因素。因NAFLD发病机制复杂、共同或相互作用,迄今仍缺乏公认、有效的治疗方法。近年来,越来越多的研究揭示了NAFLD的更多发病机制及相应的治疗前景。介绍了NAFLD的治疗进展,包括生活方式干预、药物治疗、中西医结合模式治疗以及减肥手术,其中药物治疗方面,包括临床常用药物以及最新的处于临床第二、三期试验中的药物及其作用评估。     

非酒精性脂肪肝的发病机制及肠促胰素在治疗中的研究进展

非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)是代谢综合征重要组成部分,目前治疗方法主要以改善生活方式和调整饮食结构为主,尚缺乏针对性药物.肠促胰素是肠道内分泌细胞分泌的胃肠激素,主要通过葡萄糖浓度依赖模式刺激胰岛素的分泌,胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)类降糖药物是用于治疗2型糖尿病的新型药物,其中包括GLP-1类似物和二肽基肽酶-4(dipeptidyl peptidase 4)抑制剂.基础及临床研究表明,肠促胰素可通过多种机制发挥对NAFLD的改善作用,但肠促胰素对NAFLD治疗的长期安全性仍需要进一步研究.     

甘草酸二铵脂质配位体治疗高脂饮食大鼠非酒精性脂肪性肝病疗效观察

非酒精性脂肪性肝病（NAFLD）的诊断和治疗是目前肝病研究的重点和热点之一,但由于其病因繁多且发病机制尚不十分明确,目前临床上尚无治疗此病的满意药物。甘草酸二铵脂质配位体已初步应用于临床辅助治疗多种慢性肝病,但关于其治疗MAFLD的研究报道少见,本研究通过建立高脂饮食大鼠NAFLD模型,观察甘草酸二铵脂质配位体对大鼠NAFLD的治疗效果。     

非酒精性脂肪性肝病的药物治疗研究进展

非酒精性脂肪性肝病(NAFLD)是常见的肝脏疾病,目前NAFLD的治疗仍主要依靠对患者生活方式的调整,至今药物治疗的效果不理想。随着近年来学者们对其发病机制的深入研究,NAFLD药物治疗方面取得了重大研究进展。由于患者对药物治疗的依从性较好,因此对药物在临床应用中的筛选将为NAFLD的治疗提供新的选择。该文结合近年来国内外学者对NAFLD的研究进展及临床治疗经验,综述一些有望用于NAFLD治疗的药物,包括药物作用的理论依据、作用机制、研究进展等。     

非酒精性脂肪性肝病的非药物治疗

非酒精性脂肪性肝病(NAFLD)已成为我国慢性肝病和健康体格检查时肝功能异常的首要原因。鉴于大多数NAFLD患者为亚临床的单纯性脂肪肝,且缺乏治疗NAFLD的有效药物,通过控制饮食和增加运动等非药物治疗方法减轻体质量是目前治疗NAFLD及其并发症最重要的措施。现就近年来NAFLD的非药物治疗进展作一概述和评价。     

非酒精性脂肪性肝病的治疗进展

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的治疗主要分为基础治疗、药物治疗和外科手术治疗。其中,基础治疗主要是通过行为、饮食和运动治疗来缓解NAFLD的发生和发展,药物治疗多是针对疾病不同病理环节而选取相应的药物,主要包括改善胰岛素抵抗(insulin resistance,IR)、对抗脂质过氧化损伤、保护肝细胞及纠正血脂紊乱等,外科手术治疗包括减肥手术和肝移植手术。本文对NAFLD治疗的相关进展作一概述。     

保肝药物在非酒精性脂肪性肝病中的应用

对于非酒精性脂肪性肝病（NAFLD）,采用能够直接减轻或逆转肝损害的药物治疗也是合理的选择,但目前尚无一种特效的保肝药物.多数保肝药物仅起到辅助和对症的作用。保肝药物在NAFLD治疗中的作用,主要是纠正代谢障碍、稳定肝细胞膜、抗炎、抗纤维化以阻止肝病进展。药物的作用包括：促进肝细胞再生、协助肝细胞解毒、祛除肝内过多脂肪和改善肝组织代谢等。     

Pharmacotherapy of nonalcoholic steatohepatitis: Reflections on the existing evidence

Pharmacotherapy for nonalcoholic fatty liver disease (NAFLD) has not yet been approved by the US Food and Drug Administration. Over the past decade, a large number of clinical studies have explored the safety and efficacy of different drugs in treating nonalcoholic steatohepatitis (NASH), including diet pills, antioxidants, insulin sensitizers, lipid‐lowering agents, anti‐inflammatory cytokines, cytoprotective agents and intestinal probiotics. Based on the evidence from randomized controlled trials a number of academic groups have developed guidelines for the diagnosis and management of NAFLD and NASH. In this article, we discussed the current situation of NASH pharmacotherapy.     

Current pharmacological therapies for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

Nonalcoholic fatty liver disease(NAFLD)/nonalcoholic steatohepatitis(NASH) is considered to be a hepatic manifestation of metabolic syndrome, and its incidence is rapidly increasing worldwide. It is currently the most common chronic liver disease. NASH can progress to liver cirrhosis and hepatocellular carcinoma, and may result in liver-related death. Currently, the principal treatment for NAFLD/NASH is lifestyle modification by diet and exercise. However, pharmacological therapy is indispensable because obese patients with NAFLD often have difficulty maintaining improved lifestyles. The pathogenesis of NAFLD/NASH has not been completely elucidated. However, insulin resistance, inflammatory cytokines, and oxidative stress are thought to be important in the development and/or progression of the disease. Currently, insulin sensitizers(thiazolidinediones) and antioxidants(vitamin E) seem to be the most promising therapeutic agents for NAFLD/NASH, and lipid-lowering drugs, pentoxifylline, angiotensin receptor blockers, and n-3 polyunsaturated fatty acids also have promise. However, there is a lack of consensus regarding the most effective and appropriate pharmacotherapy for NAFLD/NASH. Animal experiments suggest that herbal medicines and natural products may be promising therapeutic agents for NAFLD/NASH, but their efficacy and safety are yet to be investigated in human studies. In this paper, we review the existing and potential pharmacological therapies for NAFLD/NASH.     

Weight loss interventions and nonalcoholic fatty liver disease: Optimizing liver outcomes

The growth in prevalence of obesity, type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) has become one of the most important global health challenges. The three chronic diseases are closely linked in their epidemiology and pathophysiology. Currently, weight loss is the most effective treatment for NAFLD (even in the minority of patients with NAFLD who do not have obesity) and is recommended in all national and international guidelines. Accumulating evidence has shown that weight loss, whether achieved by diet and lifestyle interventions, bariatric surgery or pharmacotherapy, can improve biomarkers of NAFLD, as well as prevent progression and, in some cases, reverse fibrosis. There is a dose dependency of weight loss with NAFLD improvement. Pharmacotherapy with antiobesity medications, alone or in combination with intensive lifestyle interventions or other weight-loss drugs, is closing the efficacy gap between diet and exercise and weight-loss surgery in efficacy at reversing obesity. Given the importance of providing effective weight-loss treatment to patients with NAFLD, weight management services need to be made increasingly available and embedded within hepatology services. This narrative review addresses the evidence that weight loss optimizes liver outcomes in people with NAFLD.     

非酒精性脂肪性肝病的靶向治疗研究进展

非酒精性脂肪性肝病（NAFLD）是最常见的进行性疾病,临床上目前尚无疗效确切的治疗药物。介绍了脂肪酸-胆酸偶合物（FABACs）和熊去氧胆酸-溶血磷脂酰乙醇胺偶合物（UDCA-LPE）两种新型的具有NAFLD防治作用的肝靶向药物的研究进展。FABACs通过调节脂代谢,特异性的降低高脂饲料所致NAFLD的肝脏脂肪升高,预防NAFLD的形成;而且对已形成的NAFLD也有治疗作用;Ⅱ期临床研究结果显示其起效快、安全性好。UDCA-LPE在降低NAFLD的肝脏脂肪的同时,能够抑制线粒体损伤和凋亡,促进肝细胞再生,对NAFLD发展过程中的相关炎症具有显著的抑制作用。因此,FABACs和UDCA-LPE对防治NAFLD具有良好的应用前景。     

Pediatric nonalcoholic fatty liver disease: overview with emphasis on histology

Nonalcoholic fatty liver disease(NAFLD) is a disease in which excessive fat accumulates in the liver of a patient without a history of alcohol abuse.This disease includes simple steatosis and nonalcoholic steatohepatitis(NASH).NAFLD/NASH is recognized as a hepatic manifestation of metabolic syndrome.In recent years,pediatric NAFLD has increased in line with the increased prevalence of pediatric obesity.The estimated prevalence of pediatric NAFLD is 2.6%-9.6%,and it is associated with sex,age,and ethnicity.W...     

Nonalcoholic fatty liver disease: a nutritional approach

Nonalcoholic fatty liver disease (NAFLD) is among the most common causes of chronic liver disease in many countries, and its prevalence is increasing. NAFLD is often considered to be a hepatic component of metabolic syndrome, and studies have established that insulin resistance plays a major role in the pathogenesis of NAFLD. Treatments for NAFLD primarily target insulin resistance. Interestingly, the most common environmental cause of insulin resistance is diet. This article examines the correlations between NAFLD and diet and provides some diet recommendations based on the most current data available.     

非酒精性脂肪性肝病的非药物治疗进展

非酒精性脂肪性肝病(NAFLD)为国内外最常见的肝病之一,其发病率逐渐上升,但药物治疗的疗效并不确切,近年NAFLD的非药物治疗逐渐受到重视。生活方式改变和减肥手术均可对NAFLD产生积极影响,红外肝病治疗仪亦能起一定作用。尽管NAFLD的治疗手段逐渐多样化,但目前尚缺乏更多的随机对照试验来证实其有效性。     

雌激素及其受体在非酒精性脂肪性肝病发生发展中的作用机制

非酒精性脂肪性肝病(NAFLD)的发病率剧增,目前仍然缺乏有效的药物治疗。虽然对NAFLD发病相关机制研究取得了巨大进展,但对NAFLD的性别差异的理解依然不够。雌激素作为重要的性激素,通过调节情绪及能量稳态、脂肪组织功能及分布、炎症反应、胰岛素抵抗、肝脂蓄积、肝脏免疫等影响NAFLD的发生及发展。充分认识雌激素及雌激素受体在NAFLD中的作用机制,为NAFLD的治疗提供新思路。     

Nutrition and physical activity in NAFLD: an overview of the epidemiological evidence

Nonalcoholic fatty liver disease(NAFLD)has been recognized as a major health burden.The high prevalence of NAFLD is probably due to the contemporary epidemics of obesity,unhealthy dietary pattern,and sedentary lifestyle.The efficacy and safety profile of pharmacotherapy in the treatment of NAFLD remains uncertain and obesity is strongly associated with hepatic steatosis;therefore,the first line of treatment is lifestyle modification.The usual management of NAFLD includes gradual weight reduction and increas...