自噬在肝脏脂质代谢中的意义及其与胰岛素抵抗的关系

非酒精性脂肪性肝病(NAFLD)是一种与胰岛素抵抗、脂质代谢紊乱、慢性炎症以及遗传易感性强烈关联的获得性代谢应激性肝损伤,疾病谱包括单纯性脂肪肝、脂肪性肝炎及其相关纤维化、肝硬化。由于肥胖症和代谢综合征在全球的流行,近20年亚洲国家和地区NAFLD增长迅速,导致疾病谱变迁,NAFLD现已成为欧美发达国家(流行率17%~33%)以及我国经济较发达地区的第一大慢性肝病。近几年研究发现,自噬作为一种细胞程序,在介导脂质代谢过程中具有非常关键的作用,结合NAFLD的流行病学、发病机制,本文就自噬在肝脏脂质代谢中的作用意义及其与IR的关系研究现状作一综述。

Significance of autophagy in hepatic lipid metabolism and its relationship with insu- lin resistance

Non-alcoholic fatty liver disease （NAFLD） is a metabolic stress-induced liver injury disease which has a close association with insulin resistance （IR） , lipid metabolism disorders, chronic inflammation, as well as genetic pre- disposition, and its spectrum includes non-alcoholic fatty liver, non-alcoholic steatohepatitis, fibrosis and cirrhosis. The prevalence of obesity and metabolic syndrome in the world and the rapid growth of NAFLD in Asian countries and regions in recent twenty years lead to the change of spectrum, and now NAFLD has become the first chronic liver disease in the developed countries in Europe and America （prevalence of 17% ~ 33% ） as well as economic developed regions in Chi- na. Recent researches have discovered that autophagy as a kind of cell program, plays a critical role in mediating lipid metabolism. Combined with epidemiological and pathogenesis of NAFLD, this paper makes an overview on the role and significance of autophagy in liver lipid metabolism and its relationship with IR.