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| 1 | 代谢相关脂肪性肝病与代谢综合征相关性的研究进展显示文摘代谢相关脂肪性肝病(MAFLD)是一组高度异质性疾病,与代谢功能障碍密切相关,而代谢综合征是一组具有中心性肥胖、血脂异常、高血压、糖尿病或葡萄糖耐量异常的综合征。MAFLD通常被认为是代谢综合征的肝脏表现,胰岛素抵抗是MAFLD和代谢综合征的关键联系。MAFLD的患病率变化与代谢综合征流行趋势相平行,发生率依然呈上升趋势,两者互为因果,共同导致代谢心血管和肝脏疾病并发症的发生。生活方式干预是其防治的基石,多学科协作是未来MAFLD与代谢综合征患者管理的新型模式。该文对MAFLD与代谢综合征的相关性的研究进展作一综述。 | 蔡联英 王文娟 梁运啸 宋怀宇(综述) 张国(审校) | 2021 | 中国临床新医学2021，14，7： | 18 |
| 2 | MAFLD vs.NAFLD:shared features and potential changes in epidemiology,pathophysiology,diagnosis,and pharmacotherapy显示文摘Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disease worldwide,placing an increasing burden on human health.NAFLD is a complex multifactorial disease involving genetic,metabolic,and environmental factors.It is closely associated with metabolic syndrome,obesity,and type 2 diabetes,of which insulin resistance is the main pathophysiological mechanism.Over the past few decades,investigation of the pathogenesis,diagnosis,and treatments has revealed different aspects of NAFLD,challenging the accuracy of definition and therapeutic strategy for the clinical practice.Recently,experts reach a consensus that NAFLD does not reflect the current knowledge,and metabolic(dysfunction)associated fatty liver disease(MAFLD)is suggested as a more appropriate term.The new definition puts increased emphasis on the important role of metabolic dysfunction in it.Herein,the shared features and potential changes in epidemiology,pathophysiology,diagnosis,and pharmacotherapy of the newly defined MAFLD,as compared with the formerly defined NAFLD,are reviewed for updating our understanding. | Ying-Xin Xian Jian-Ping Weng Fen Xu | 2021 | Chinese Medical Journal2021，，1： | 18 |
| 3 | 重视代谢相关脂肪性肝病的特征与预后临床研究显示文摘非酒精性脂肪性肝病(NAFLD)是与胰岛素抵抗和遗传易感密切相关的以肝细胞大泡性脂肪变为病理特征的慢性代谢应激性肝脏疾病,疾病谱主要包括非酒精性单纯性脂肪肝、非酒精性脂肪性肝炎(NASH)及其相关的肝硬化和肝细胞癌(HCC)[1]。鉴于绝大多数NAFLD患者是肥胖症、2型糖尿病(T2DM)、代谢综合征累及肝脏的病理学表现,2020年国际专家小组将NAFLD更名为代谢功能障碍相关脂肪性肝病(MAFLD),亚太地区肝病协会、拉丁美洲肝病协会随后正式发布MAFLD诊疗指南,中东和北非肝病专家组、中华医学会肝病学分会和全球不少专家对NAFLD的更名和新的术语及其工作定义持赞成态度[2-6]。 | 王梦雨 杨蕊旭 范建高 | 2021 | 实用肝脏病杂志2021，24，3： | 12 |
| 4 | 血清全氟化合物与代谢相关脂肪性肝病患病风险的关系显示文摘基于2017~2018年美国国家营养调查与健康调查数据集(NHANES),探究血清全氟化合物(PFAS)对代谢相关脂肪性肝病(MAFLD)的影响以及在不同人群中的效应差异.采用Logistic回归模型和限制性立方样条评估各污染物的效应和剂量反应关系.结果表明:单污染物模型发现血清全氟辛烷磺酸(PFOS)、全氟己烷磺酸(PFHxS)、全氟癸酸(PFDA)与MAFLD患病风险呈负向关联,OR值分别为0.64(95%CI:0.45~0.91)、0.65(95%CI:0.46~0.93)、0.45(95%CI:0.30~0.67);多污染物模型中,与最低四分位数浓度(Q1)相比,血清全氟壬酸(PFNA)浓度处于Q2、Q3、Q4水平时,患MAFLD风险分别增加62%(OR=1.62,95%CI:1.10~2.39)、62%(OR=1.62,95%CI:1.01~2.60)、172%(OR=2.72,95%CI:1.53~4.84),且呈正向线性剂量-反应关系(Poverall=0.002).血清PFDA处于Q2、Q3、Q4水平时,可导致MAFLD风险分别减少39%(OR=0.61,95%CI:0.44~0.85)、46%(OR=0.54,95%CI:0.34~0.84)、74%(OR=0.26,95%CI:0.15~0.45),呈负向线性剂量-反应关系(Poverall<0.001).亚组分析显示血清PFDA对51~65岁人群罹患MAFLD的影响更为显著,而血清PFNA对女性的影响较大.综上所述,血清PFNA及PFDA与MAFLD患病风险关联,血清PFNA暴露是MAFLD发生的重要危险因素,而血清PFDA是保护因素,女性、中老年人群是潜在的易感人群. | 张露露 刘婧 贺颖倩 赵亚楠 郑山 王敏珍 | 2023 | 中国环境科学2023，43，2： | 2 |
| 5 | 儿童脂肪性肝病命名探析显示文摘肥胖是多种重大慢性疾病的危险因素,其中肝脏疾病尤其是脂肪性肝病的发生与肥胖密切相关。非酒精性脂肪性肝病(NAFLD)已成为我国儿童青少年慢性肝病的最常见类型,给社会造成了严重的经济和公共卫生负担。随着对疾病研究的深入,2020年国际共识小组建议将NAFLD更新为代谢障碍相关脂肪性肝病(MAFLD)。而为了积极防控肥胖基础上的脂肪肝大流行,本文提出在儿童中应用'肥胖相关脂肪性肝病(OAFLD)'这一新名称。本文将从儿童脂肪性肝病疾病命名的背景与机制出发,探讨NAFLD、MAFLD、OAFLD在儿童青少年中应用的优劣。 | 濮佳琦 王森杰 薛初晴 周雪莲 吴蔚 傅君芬 | 2023 | 中华儿科杂志2023，61，2： | 2 |
| 6 | 代谢相关脂肪性肝病慢加急性肝衰竭的过去、现状与未来显示文摘代谢相关脂肪性肝病(MAFLD)是目前脂肪性肝病领域的热议话题,它已成为全球最常见的慢性肝病。预计在未来的20年内,MAFLD及相关肝硬化的发病率仍将不断增加,成为新的全球性健康问题。慢加急性肝衰竭(ACLF)是指在慢性肝病基础上,短期内发生的急性或亚急性肝功能失代偿状态,以腹水、黄疸、凝血功能障碍和肝性脑病为主要表现的临床症候群。在有限的资料基础上,对MAFLD-ACLF的流行病学、发病机制和治疗管理策略等问题进行讨论和展望。 | 缪磊 唐梁杰 范建高 郑明华 | 2021 | 临床肝胆病杂志2021，37，4： | 2 |
| 7 | 姜黄素类药物治疗代谢相关脂肪性肝病的研究进展显示文摘近年来代谢相关脂肪性肝病(metabolic-associated fatty liver disease,MAFLD)的发病率逐年增加,已成为威胁人类健康的最常见的慢性肝病,目前临床上尚没有治疗MAFLD的有效药被批准使用。多项体内外研究证实姜黄素可通过影响脂肪酸代谢、胰岛素抵抗、肝脏炎症及肠道菌群进程来改善MAFLD。本文总结了近5年来姜黄素类药物治疗MAFLD在动物实验和临床研究中的进展,以期为姜黄素类药物治疗代谢类相关疾病提供更多可能。 | 孙子林 肖爽 彭明利 | 2023 | 中国现代应用药学2023，40，7： | 2 |
| 8 | 从非酒精性脂肪性肝病到代谢相关脂肪性肝病给我们带来的思考显示文摘非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)常用于描述无酒精影响及其他已知病因的与酒精性脂肪性肝病拥有相同病理改变的肝病。这一概念出现于20世纪80年代,到21世纪,逐渐在临床诊疗中得到应用。随着时间的推移,NAFLD发病率逐年上升,且趋于年轻化。40多年来,关于NAFLD的研究渐渐深入,人们发现NAFLD这一术语逐渐无法代表该病本质。2020年初,随着一份国际专家共识声明的发表,NAFLD正式更名为代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)。新的术语与诊断方法摒弃了原来排除性的诊断条件,使得医务人员的诊疗思维更清晰。它不再简单的以是否存在脂肪性肝炎(non-alcoholic steatohepatitis,NASH)作为严重程度的划分条件,而是通过肝脏炎症活动度的肝脏纤维化程度来描述疾病的发展过程,更好地服务于临床与科研。本文旨在通过收集整理相关资料阐述NAFLD的局限性及MAFLD的诊疗优势,向读者展示从NAFLD到MAFLD的演变进程及原因,介绍现阶段MAFLD的诊疗措施,并呼吁广大学者及研究人员对MAFLD进行更深入、细致的研究。 | 郑莹 李小明 | 2022 | 胃肠病学和肝病学杂志2022，31，11： | 1 |
| 9 | 新型降糖药物在代谢相关脂肪性肝病中的适应证、作用和地位显示文摘代谢相关脂肪性肝病(MAFLD)是最常见的慢性肝病之一,由其导致的肝硬化和肝细胞癌发病率也在逐年增加。MAFLD的重要危险因素之一就是糖尿病,尤其是2型糖尿病(T2DM),二者互为因果。由于MAFLD的发病机制尚未完全明确,目前仍没有特异性治疗药物。近年来在各种新型降糖药物的临床试验中发现,胰高血糖素样肽-1受体激动剂(GLP-1RAs)、二肽基肽酶-4(DPP-4)抑制剂、钠-葡萄糖共转运体-2(SGLT-2)抑制剂和噻唑烷二酮类(TZDs)等对MAFLD具有减轻肝脏脂肪变性、炎症和纤维化程度的潜力,但尚未被公认。本文就这4类新型降糖药物在MAFLD治疗中的研究进展、作用地位、有效性和安全性等方面进行综述。 | 缪磊 徐静 郑明华 | 2021 | 世界临床药物2021，42，8： | 1 |
| 10 | A novel radiomics signature based on T2-weighted imaging accurately predicts hepatic inflammation in individuals with biopsy-proven nonalcoholic fatty liver disease:a derivation and independent validation study显示文摘Background:Currently,there are no effective methods for assessing hepatic inflammation without resorting to histological examination of liver tissue obtained by biopsy.T2-weighted images(T2WI)are routinely obtained from liver magnetic resonance imaging(MRI)scan sequences.We aimed to establish a radiomics signature based on T2WI(T2-RS)for assessment of hepatic inflammation in people with nonalcoholic fatty liver disease(NAFLD).Methods:A total of 203 individuals with biopsy-confirmed NAFLD from two independent Chinese cohorts with liver MRI examination were enrolled in this study.The hepatic inflammatory activity score(IAS)was calculated by the unweighted sum of the histologic scores for lobular inflammation and ballooning.One thousand and thirty-two radiomics features were extracted from the localized region of interest(ROI)in the right liver lobe of T2WI and,subsequently,selected by minimum redundancy maximum relevance and least absolute shrinkage and selection operator(LASSO)methods.The T2-RS was calculated by adding the selected features weighted by their coefficients.Results:Eighteen radiomics features from Laplacian of Gaussian,wavelet,and original images were selected for establishing T2-RS.The T2-RS value differed significantly between groups with increasing grades of hepatic inflammation(P<0.01).The T2-RS yielded an area under the receiver operating characteristic(ROC)curve(AUROC)of 0.80[95%confidence interval(CI):0.71-0.89]for predicting hepatic inflammation in the training cohort with excellent calibration.The AUROCs of T2-RS in the internal cohort and external validation cohorts were 0.77(0.61-0.93)and 0.75(0.63-0.84),respectively.Conclusions:The T2-RS derived from radiomics analysis of T2WI shows promising utility for predicting hepatic inflammation in individuals with NAFLD. | Zhong-Wei Chen Huan-Ming Xiao Xinjian Ye Kun Liu Rafael S.Rios Kenneth I.Zheng Yi Jin Giovanni Targher Christopher D.Byrne Junping Shi Zhihan Yan Xiao-Ling Chi Ming-Hua Zheng | 2022 | Hepatobiliary Surgery and Nutrition2022，11，2： | 1 |
| 11 | Metabolic associated fatty liver disease(MAFLD):a milestone in the history of fatty liver disease显示文摘With the widespread increase in energy intake and physical inactivity,the prevalence of metabolic health is declining.Consequently,metabolic associated fatty liver disease(MAFLD)[formerly known as non-alcoholic fatty liver disease(NAFLD)]has risen in prevalence and present a significant challenge to global health causing considerable morbidity and mortality,particularly when fibrosis is present(1). | Jawaher Alharthi Mohammed Eslam | 2021 | Hepatobiliary Surgery and Nutrition2021，10，5： | 1 |
| 12 | 新疆柯尔克孜族成人非酒精性脂肪肝病患病率及临床特征分析显示文摘目的探讨新疆柯尔克孜族成人非酒精性脂肪性肝病(NAFLD)的患病率及临床特征。方法选取2018年新疆维吾尔自治区阿合奇县地区常住柯尔克孜族成人全民体检数据,共19843例,分析NAFLD患病率。经腹部B超确诊NAFLD的1396例为病例组,按1∶3的比例选取年龄、性别、地区相匹配的4188例非NAFLD者为对照组;分析NAFLD患者临床特征及其危险因素。结果柯尔克孜族成人NAFLD总体、男性、女性患病率分别为7.0%、7.8%、6.2%(标化后分别为6.8%、7.5%、6.0%),男性患病率高于女性(P<0.01)。肥胖、糖尿病及高血压组的NAFLD患病率明显升高,分别为19.0%、20.6%、18.5%。NAFLD组的BMI、腰围、甘油三酯、AST、ALT均高于对照组(均P<0.01)。NAFLD人群中有17.2%合并一种代谢紊乱疾病,62.0%合并两种代谢紊乱。Logistics回归分析显示:腰围(OR=4.08,95%CI:3.04~5.10)、空腹血糖(OR=3.76,95%CI:2.86~4.93)、BMI(OR=3.32,95%CI:2.16~4.38)是NAFLD发生的主要危险因素;而文化程度(OR=0.42,95%CI:0.24~0.69)、运动(OR=0.68,95%CI:0.45~0.96)是保护因素。结论柯尔克孜族成人NAFLD患病率低于全国水平,NAFLD患者常合并多种代谢紊乱。腰围、空腹血糖、BMI是其患NAFLD的主要危险因素,而文化程度、运动为保护因素。 | 诸葛瑾慧 苏银霞 张明琛 姚华 | 2021 | 公共卫生与预防医学2021，32，5： | 1 |
| 13 | The uprising of metabolic dysfunction-associated fatty liver disease(MAFLD)in acute-on-chronic liver failure(ACLF)显示文摘Metabolic dysfunction-associated fatty liver disease(MAFLD)(1)is currently the leading cause of chronic liver disease in the United States(US)and Europe,and the second leading cause for liver transplantation(2).Despite advancements in knowledge over the past decade,MAFLD-related cirrhosis is the most rapidly growing etiology for acute-on-chronic liver failure(ACLF)in the US(3-5).ACLF is a syndrome characterized by acute deterioration of cirrhosis and extrahepatic failure of 1 or more organs.ACLF represents a significant healthcare burden,and is associated with high short-term mortality.Recently,an epidemiology study showed a 3-fold increase in MAFLD-related ACLF waitlisted patients in the United Network for Organ Sharing(UNOS)database from 2005 to 2017(4),and a similar trend was observed in the European Liver Transplant Registry(ELTR)database(5).This is particularly concerning,as the quick rise in MAFLD-related ACLF has created a major gap between the number of patients requiring a liver transplant and the number of available liver donors. | Kenneth I.Zheng Ming-Hua Zheng | 2021 | Hepatobiliary Surgery and Nutrition2021，10，6： | 1 |
| 14 | 饮食行为与非酒精性脂肪性肝病的关系显示文摘非酒精性脂肪性肝病(NAFLD)的患病率逐年攀升,对全球公共卫生造成重大负担。NAFLD发病与肥胖、胰岛素抵抗、饮食等因素息息相关,其中饮食是NAFLD防治的核心与基石。鉴于既往研究侧重于不同饮食成分、结构、方案与NAFLD的关系,而较少探讨整体饮食行为对NAFLD的影响。故本文将饮食行为对NAFLD的影响进行综述,旨在为NAFLD的防治及指导患者合理饮食行为习惯提供参考依据。 | 袁乙富 曹勤 蒋元烨 | 2023 | 临床肝胆病杂志2023，39，2： | 1 |
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