Abstract:
Malnutrition is a public health epidemic mainly targeting poverty-stricken people, young ones, older people, pregnant women, and individuals with metabolic disorders. Severe malnutrition is linked with several metabolic defects, such as hepatic dysfunction, hypertension, cardiovascular disease, and osteoarthritis. The proper functioning of the liver plays a crucial role in ensuring the supply of nutrients to the body. Consequently, inadequate nutrition can lead to severe periportal hepatic steatosis due to compromised mitochondrial and peroxisome functions. Reduced protein intake disrupts essential metabolic processes like the TCA cycle, oxidative phosphorylation, and β-oxidation, ultimately affecting ATP production. Furthermore, this can trigger a cascade of events, including disturbances in amino acid metabolism, iron metabolism, and gut microbiota, which activate genes involved in de novo lipogenesis, leading to the accumulation of lipids in the liver. The condition, in prolonged cases, progresses to steatohepatitis and liver fibrosis. Limited therapeutic solutions are available; however, few dietary supplements and drugs have demonstrated positive effects on the growth and health of malnourished individuals. These supplements improve parameters such as inflammatory and oxidative status, reduce triglyceride accumulation, enhance insulin sensitivity, and downregulate gene expression in hepatic lipid metabolism. This review elucidates the various mechanisms involved in malnutrition-associated steatohepatitis and provides an overview of the available approaches for treating this condition.
摘要:
营养不良是一种主要针对贫困人口的公共卫生流行病,年轻人,老年人,孕妇,和代谢紊乱的个体。严重的营养不良与几种代谢缺陷有关,如肝功能障碍,高血压,心血管疾病,和骨关节炎。肝脏的正常运作在确保身体营养供应方面起着至关重要的作用。因此,由于线粒体和过氧化物酶体功能受损,营养不足可导致严重的门静脉周围肝脂肪变性。蛋白质摄入的减少会破坏必需的代谢过程,如TCA循环,氧化磷酸化,和β-氧化,最终影响ATP生产。此外,这可以触发一系列事件,包括氨基酸代谢紊乱,铁代谢,和肠道微生物群,激活参与从头脂肪生成的基因,导致脂质在肝脏中积累。条件,在长时间的情况下,进展为脂肪性肝炎和肝纤维化。有限的治疗解决方案是可用的;然而,很少有膳食补充剂和药物对营养不良者的生长和健康表现出积极作用。这些补充剂可改善炎症和氧化状态等参数,减少甘油三酯积累,增强胰岛素敏感性,并下调肝脏脂质代谢中的基因表达。这篇综述阐明了营养不良相关脂肪性肝炎的各种机制,并概述了治疗这种疾病的可用方法。