PDF(Pubmed)
Abstract：
The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) is significant, impacting almost one-third of the global population. MAFLD constitutes a primary cause of end-stage liver disease, liver cancer and the need for liver transplantation. Moreover, it has a strong association with increased mortality rates due to various extrahepatic complications, notably cardiometabolic diseases. While MAFLD is typically correlated with obesity, not all individuals with obesity develop the disease and a significant percentage of MAFLD occurs in patients without obesity, termed lean MAFLD. The clinical features, progression and underlying physiological mechanisms of patients with lean MAFLD remain inadequately characterized. The present review aims to provide a comprehensive summary of current knowledge on lean MAFLD and offer a perspective on defining MAFLD in individuals with normal weight. Key to this process is the concept of metabolic health and flexibility, which links states of dysmetabolism to the development of lean MAFLD. This perspective offers a more nuanced understanding of MAFLD and its underlying mechanisms and highlights the importance of considering the broader metabolic context in which the disease occurs. It also bridges the knowledge gap and offers insights that can inform clinical practice.
摘要：
代谢功能障碍相关脂肪性肝病（MAFLD）的患病率显着，影响了全球近三分之一的人口。MAFLD构成终末期肝病的主要原因，肝癌和肝移植的需要。此外，它与各种肝外并发症导致的死亡率增加密切相关，特别是心脏代谢疾病。虽然MAFLD通常与肥胖相关，并非所有肥胖患者都会患上这种疾病，并且大部分MAFLD发生在无肥胖患者中，称为精益MAFLD。临床特征，瘦MAFLD患者的进展和潜在的生理机制仍未得到充分表征。本综述旨在提供有关瘦MAFLD的最新知识的全面总结，并提供定义正常体重个体MAFLD的观点。这个过程的关键是代谢健康和灵活性的概念，这将代谢异常的状态与瘦肉MAFLD的发展联系起来。这种观点提供了对MAFLD及其潜在机制的更细致的理解，并强调了考虑疾病发生的更广泛代谢背景的重要性。它还弥合了知识差距，并提供了可以为临床实践提供信息的见解。
