代谢相关脂肪性肝病： 全身代谢性紊乱的核心枢纽之一

周蒙; 薄涛; 范修德; 赵家军

doi:10.12449/JCH250902

代谢相关脂肪性肝病：全身代谢性紊乱的核心枢纽之一

DOI: 10.12449/JCH250902

山东第一医科大学附属省立医院内分泌代谢病科，“内分泌糖脂代谢与脑老化”教育部重点实验室，济南 250000

基金项目:

国家自然科学基金 (82130025)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：赵家军负责设计论文框架和思路，指导撰写、修改文章并最后定稿；周蒙、范修德负责文献查阅；周蒙、薄涛负责初稿写作。

详细信息

通信作者:
赵家军， jjzhao@sdu.edu.cn （ORCID： 0000-0003-3267-9292）

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出版历程
- 收稿日期: 2025-06-17
- 录用日期: 2025-07-08
- 出版日期: 2025-09-25

Metabolic dysfunction-associated fatty liver disease： A central hub in systemic metabolic dysregulation

Department of Endocrinology，Shandong Provincial Hospital Affiliated to Shandong First Medical University；Key Laboratory of Endocrine Glucose Lipids Metabolism and Brain Aging，Ministry of Education，Jinan 250000，China

Research funding:

National Natural Science Foundation of China (82130025)

More Information

Corresponding author: ZHAO Jiajun， jjzhao@sdu.edu.cn （ORCID： 0000-0003-3267-9292）

摘要

摘要: 代谢相关脂肪性肝病（MAFLD）的全球患病率持续上升，且被认为是多种代谢相关疾病的重要危险因素。然而，目前临床仍主要采用单一病种的管理模式，对MAFLD在代谢共病防控中的核心作用及其系统性影响缺乏充分认识。本文综述了MAFLD作为全身代谢疾病网络的始动因素和关键节点的循证医学依据，重点阐述肝脏胰岛素抵抗、脂毒性损伤、炎症反应及肝源性激素紊乱等病理机制如何介导心血管疾病、慢性肾病、糖尿病等多器官代谢紊乱的发生发展。结合最新国内外指南和共识，提出多学科协作的综合管理策略，包括肝脏与血糖的联合干预和“心血管-肝脏-肾脏”跨器官干预模式，并倡导将临床治疗模式从传统的肝脏局部病变控制，转变为以肝脏为中心的全身代谢精准防控体系，旨在更有效地延缓MAFLD及其相关多系统并发症的进展。
- 代谢相关脂肪性肝病 /
- 代谢综合征 /
- 胰岛素抵抗
Abstract: The prevalence rate of metabolic associated fatty liver disease （MAFLD） is steadily increasing worldwide， and MAFLD is now considered a significant risk factor for a wide range of metabolic comorbidities. However， current clinical management strategies often address MAFLD from a single-disease perspective， lacking a comprehensive understanding of the central role and systemic impact of MAFLD in the prevention and control of metabolic comorbidities. This article reviews the current evidence supporting MASLD as both a trigger and a key node in systemic metabolic dysfunction and elaborates on how hepatic insulin resistance， lipotoxic injury， inflammatory responses， and dysregulation of hepatokines mediate organ-specific metabolic disorders including cardiovascular disease， chronic kidney disease， and diabetes. With reference to the latest national and international guidelines， this article proposes an integrated multidisciplinary management strategy， including liver-glucose joint intervention and a cross-organ “cardio-renal-hepatic” strategy， and it also advocates for a paradigm shift from conventional liver-focused management toward liver-centered systemic metabolic control， in order to effectively delay the progression of MAFLD and its related multisystem complications.
- Metabolic Dysfunction-associated Fatty Liver Disease /
- Metabolic Syndrome /
- Insulin Resistance

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参考文献(27)

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