代谢相关脂肪性肝病多器官损伤的病理机制

蒋丽娜; 赵景民

doi:10.12449/JCH250903

代谢相关脂肪性肝病多器官损伤的病理机制

DOI: 10.12449/JCH250903

蒋丽娜,
赵景民^, ,

中国人民解放军总医院第五医学中心，北京 100039

基金项目:

国家重点研发计划 (2023YFC2308104);

国家重点研发计划 (2023YFC2308100);

北京市医院管理中心临床医学发展专项经费 (ZLRK202301);

国家自然科学基金 (92159305)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：蒋丽娜负责文献检索，初稿撰写；赵景民负责拟定写作思路，指导撰写文章及最后定稿。

详细信息

通信作者:
赵景民， jmzhao302@163.com （ORCID： 0000-0003-4345-2149）

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出版历程
- 收稿日期: 2025-07-04
- 录用日期: 2025-08-07
- 出版日期: 2025-09-25

Pathological mechanism of multi-organ injuries in metabolic dysfunction-associated fatty liver disease

Lina JIANG,
Jingmin ZHAO^{,
,}

The Fifth Medical Center of Chinese PLA General Hospital，Beijing 100039，China

Research funding:

National Key RD Program of China (2023YFC2308104);

National Key RD Program of China (2023YFC2308100);

Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (ZLRK202301);

National Natural Science Foundation of China (92159305)

More Information

Corresponding author: ZHAO Jingmin， jmzhao302@163.com （ORCID： 0000-0003-4345-2149）

摘要

摘要: 代谢相关脂肪性肝病（MAFLD）及其进展形式代谢相关脂肪性肝炎（MASH）已成为全球慢性肝病的重要类型，且与代谢综合征密切相关。肝脏-肝外相关器官/组织轴与肝内炎症的“溢出效应”在MAFLD/MASH的发生发展中起关键作用，并对多器官代谢稳态产生显著影响，导致包括心血管疾病、肌少症、慢性肾病、非酒精性脂肪性胰腺病、多囊卵巢综合征、肝细胞癌及多种相关实体瘤等肝外多器官损伤。MAFLD与肝癌及肝外恶性肿瘤的发生发展存在显著流行病学关联，相关肿瘤发生风险与持续的代谢紊乱、慢性低度炎症、肠道微生态失调等多因素相关。最新研究视角已从单纯肝脏病变扩展到全身代谢网络失调，强调肝脏与肝外器官的交互作用在疾病进展中的核心地位。本文重点探讨MAFLD/MASH的发病机制，并对相关肝外多器官损伤机制进行述评。
- 代谢相关脂肪性肝病 /
- 多器官损伤 /
- 病理学
Abstract: Metabolic dysfunction-associated fatty liver disease （MAFLD） and its progressive form， metabolic dysfunction-associated steatohepatitis （MASH）， have emerged as significant types of chronic liver disease worldwide and are closely associated with metabolic syndrome. The liver-extrahepatic organ/tissue axis and the “spill-over effect” of intrahepatic inflammation play pivotal roles in the pathogenesis and progression of MAFLD/MASH， significantly impacting multi-organ metabolic homeostasis and leading to various extrahepatic injuries. These include cardiovascular diseases， sarcopenia， chronic kidney disease， non-alcoholic fatty pancreas disease， polycystic ovary syndrome， hepatocellular carcinoma， and various related solid tumors. There is a notable epidemiological link between MAFLD and the development of both liver cancer and extrahepatic malignancies. The risk of associated tumorigenesis is related to multiple factors， including persistent metabolic disorders， chronic low-grade inflammation， and gut microbiota dysbiosis. Recent research perspectives have shifted from focusing solely on hepatic pathology to recognizing systemic metabolic dysregulation， emphasizing the central role of liver-extrahepatic organ interactions in disease progression. This article aims to explore the pathogenesis of MAFLD/MASH and to review the mechanisms underlying related multi-organ extrahepatic injuries.
- Metabolic Dysfunction-associated Fatty Liver Disease /
- Multi-organ Injuries /
- Pathology

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