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肠-肝轴与肝脏铁过载的交互作用对代谢相关脂肪性肝病的影响及相关干预策略
DOI: 10.12449/JCH260926
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：梁莹负责文献查阅，初稿写作；张晶晶负责文献查阅；赵文霞负责设计论文框架和思路；刘晓彦负责指导撰写、修改文章并最后定稿。
Impact of the interaction between the gut-liver axis and hepatic iron overload on metabolic dysfunction-associated fatty liver disease and related intervention strategies
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摘要: 代谢相关脂肪性肝病（MAFLD）是一种主要由营养过剩和胰岛素抵抗导致的慢性、全球性肝脏疾病，其疾病谱广泛，发病率高，可进一步发展为肝炎、肝硬化及肝癌。MAFLD的发病涉及多个环节，但其具体作用机制尚未完全阐明。本文围绕“肠-肝轴紊乱与肝脏铁过载”这一前沿理论，归纳总结二者调控肝内脂毒性损伤、氧化应激、胰岛素抵抗及铁死亡的分子机制，揭示其协同促进MAFLD进展的病理生理过程，同时基于此理论阐述MAFLD的治疗策略，为其临床诊疗提供参考。Abstract: Metabolic dysfunction-associated fatty liver disease （MAFLD） is a chronic liver condition worldwide mainly caused by overnutrition and insulin resistance （IR）. It encompasses a broad disease spectrum with a high incidence rate and may further progress to hepatitis， liver cirrhosis， and hepatocellular carcinoma. The pathogenesis of MAFLD involves multiple factors， but the specific mechanism of action has not yet been fully elucidated. This article reviews the cutting-edge theory of “gut-liver axis dysfunction-hepatic iron overload”， summarizes the molecular mechanisms by which these two factors regulate intrahepatic lipotoxicity， oxidative stress， IR， and ferroptosis， reveals the pathophysiological process by which they synergistically promote the progression of MAFLD， and elaborates on the therapeutic strategies for MAFLD on this basis， so as to provide a reference for clinical diagnosis and treatment.
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