Fatty liver

脂肪肝
  • 文章类型: Journal Article
    Metabolic dysfunction-associated steatotic liver disease (MASLD) comprises a spectrum of liver diseases that span simple steatosis, metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis and may progress to cirrhosis and cancer. The pathogenesis of MASLD is multifactorial and is driven by environmental, genetic, metabolic and immune factors. This review will focus on the role of the type 3 cytokines IL-17 and IL-22 in MASLD pathogenesis and progression. IL-17 and IL-22 are produced by similar adaptive and innate immune cells such as Th17 and innate lymphoid cells, respectively. IL-17-related signaling is upregulated during MASLD resulting in increased chemokines and proinflammatory cytokines in the liver microenvironment, enhanced recruitment of myeloid cells and T cells leading to exacerbation of inflammation and liver disease progression. IL-17 may also act directly by activating hepatic stellate cells resulting in increased fibrosis. In contrast, IL-22 is a pleiotropic cytokine with a dominantly protective signature in MASLD and is currently being tested as a therapeutic strategy. IL-22 also exhibits beneficial metabolic effects and abrogates MASH-related inflammation and fibrosis development via inducing the production of anti-oxidants and anti-apoptotic factors. A sex-dependent effect has been attributed to both cytokines, most importantly to IL-22 in MASLD or related conditions. Altogether, IL-17 and IL-22 are key effectors in MASLD pathogenesis and progression. We will review the role of these two cytokines and cells that produce them in the development of MASLD, their interaction with host factors driving MASLD including sexual dimorphism, and their potential therapeutic benefits.
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  • 文章类型: Journal Article
    过多的非酯化脂肪酸(NEFA)会损害细胞代谢,并会在围产期引起奶牛脂肪肝的形成。黄芩苷,一种活性类黄酮,在减轻脂质积累和改善脂肪肝疾病的发展方面具有巨大的潜在功效。然而,其机制尚不清楚。这里,利用网络药理学和体外实验,探讨了黄芩苷在系统水平上的潜在作用机制。首先,预测黄芩苷与脂肪肝的关系,然后构建蛋白质-蛋白质相互作用(PPI)网络。此外,通过注释数据库进行京都基因和基因组百科全书(KEGG)(q值)途径富集,可视化,和集成发现(DAVID)服务器。最后,证实了NEFA体外处理牛肝细胞的网络分析结果。结果显示,通过网络药理学预测了黄芩苷治疗肝脏脂肪的33个相关靶点,并通过KEGG数据库提取前20条相关通路。黄芩苷处理可以减少NEFA处理的牛肝细胞中甘油三酯(TAG)含量和脂滴积累,其机制与抑制脂质合成和促进脂质氧化有关。黄芩苷对脂肪肝的缓解作用可能与溶质载体家族成员4(SLC2A4)的上调有关,下调AKT丝氨酸/苏氨酸激酶1(AKT1),过氧化物酶体增殖物激活受体γ(PPARG),表皮生长因子受体(EGFR),肿瘤坏死因子(TNF),白细胞介素6(IL-6)相关。这些结果表明,黄芩苷可能调节关键的炎症标志物,和脂肪生成过程,以防止奶牛脂肪肝的发展。
    Excessive nonesterified fatty acids (NEFA) impair cellular metabolism and will induce fatty liver formation in dairy cows during the periparturient. Baicalin, an active flavonoid, has great potential efficacy in alleviating lipid accumulation and ameliorating the development of fatty liver disease. Nevertheless, its mechanism remains unclear. Here, the potential mechanism of baicalin on system levels was explored using network pharmacology and in vitro experiments. Firstly, the target of baicalin and fatty liver disease was predicted, and then the protein-protein interaction (PPI) network was constructed. In addition, the Kyoto Encyclopedia of Genes and Genomes (KEGG) (q-value) pathway enrichment is performed through the Database for Annotation, Visualization, and Integrated Discovery (DAVID) server. Finally, the results of the network analysis of the in vitro treatment of bovine hepatocytes by NEFA were confirmed. The results showed that 33 relevant targets of baicalin in the treatment of liver fatty were predicted by network pharmacology, and the top 20 relevant pathways were extracted by KEGG database. Baicalin treatment can reduce triglyceride (TAG) content and lipid droplet accumulation in NEFA-treated bovine hepatocytes, and the mechanism is related to inhibiting lipid synthesis and promoting lipid oxidation. The alleviating effect of baicalin on fatty liver may be related to the up-regulation of solute vector family member 4 (SLC2A4), Down-regulated AKT serine/threonine kinase 1 (AKT1), Peroxisome proliferator-activated receptor gamma (PPARG), Epidermal growth factor receptor (EGFR), tumor necrosis factor (TNF), Interleukin 6 (IL-6) were associated. These results suggested that baicalin may modulate key inflammatory markers, and lipogenesis processes to prevent fatty liver development in dairy cows.
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  • 文章类型: Journal Article
    肝纤维化的存在是进展为肝硬化的最重要指标。肝脏硬度的无创测量对于检测纤维化至关重要。振动控制的瞬态弹性成像是用于此目的的最有用的方法之一。我们旨在使用iLivTouch©和FibroScan®弹性成像设备比较肝脏硬度和脂肪变性的测量结果。这项研究包括了两百三十七名连续的慢性肝炎成年患者。在同一天用iLivTouch和FibroScan测量肝脏硬度和脂肪变性。31名患者在同一天使用弹性成像程序进行了肝活检。将iLivTouch和FibroScan的诊断性能与天冬氨酸转氨酶与血小板比率指数(APRI)进行比较,纤维化-4(FIB-4),和非酒精性脂肪性肝病纤维化评分(NFS)。使用iLivTouch和FibroScan获得的肝脏硬度测量值的中位数为10.3(2.9至46.3)和7.2(2.5至75),分别。使用iLivTouch的超声衰减参数测量的平均脂肪变性为245.51±45.79,而使用FibroScan的平均受控衰减参数测量为259.37±75.0。在亚组分析中,iLivTouch检测显著纤维化的AUC[0.83,(P=0.002)]最低限度高于其他非侵入性方法[NFS为0.82(P=0.003),FibroScan为0.80(P=.006),FIB-4为0.68(P=0.089),APRI为0.53(P=0.76)]。iLivTouch和FibroScan的硬度和脂肪变性测量结果不相似。iLivTouch检测显著和晚期纤维化的准确性最低限度地较高。大型临床试验是必要的,以支持这些发现。
    The presence of liver fibrosis is the most important indicator of progression to cirrhosis. Noninvasive measurement of liver stiffness is crucial for detecting fibrosis. Vibration-controlled transient elastography is one of the most useful methods for this purpose. We aimed to compare the liver stiffness and steatosis measurements with iLivTouch© and the FibroScan© elastography devices Two hundred thirty-seven consecutive adult patients with chronic hepatitis were included in the study. The liver stiffness and steatosis were measured with iLivTouch and FibroScan on the same day. Thirty-one patients had liver biopsies on the same day with elastography procedures. The diagnostic performances of iLivTouch and FibroScan were compared to aspartate aminotransferase to platelet ratio index (APRI), Fibrosis-4 (FIB-4), and nonalcoholic fatty liver disease fibrosis score (NFS). The liver stiffness measurements obtained using iLivTouch and FibroScan had median value of 10.3 (ranging from 2.9 to 46.3) and 7.2 (ranging from 2.5 to 75), respectively. The mean steatosis measurements using ultrasound attenuation parameter with iLivTouch were 245.51 ± 45.79, while the mean controlled attenuation parameter measurements using FibroScan were 259.37 ± 75.0. In subgroup analysis, the AUC of iLivTouch on detecting signiicant fibrosis [0.83, (P = .002)] was minimally higher than other noninvasive methods [0.82 for NFS (P = .003), 0.80 for FibroScan (P = .006), 0.68 for FIB-4 (P = .089), and 0.53 for APRI (P = .76)]. The stiffness and steatosis measurements with iLivTouch and FibroScan were not similar. The accuracy of iLivTouch in detecting significant and advanced fibrosis was minimally higher. Large clinical trials are necessary to support these findings.
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  • 文章类型: Journal Article
    背景:现有研究对免疫细胞之间的联系提出了有限和不同的发现,血浆代谢物,和代谢功能障碍相关的脂肪变性肝病(MASLD)。本研究旨在探讨免疫细胞与MASLD之间的因果关系。此外,我们旨在鉴定和量化代谢物的潜在介导作用.
    方法:孟德尔随机化(MR)分析使用来自MASLD全基因组关联研究的两个数据样本进行,包括2568名患者和409,613名对照个体。此外,一项介导的MR研究用于定量代谢物介导的免疫细胞对MASLD的影响.
    结果:在这项研究中,八种免疫表型与MASLD的风险有关,35种代谢物/代谢物比率与MASLD的发生有关。此外,共有6种免疫表型和代谢因子组合显示了对MASLD发生的影响,虽然代谢产物的介导作用不显著。
    结论:我们的研究表明,某些免疫表型和代谢物/代谢物比率与MASLD具有独立的因果关系。此外,我们确定了与MASLD风险增加相关的特定代谢物/代谢物比率.然而,它们在免疫表型和MASLD之间的因果关系中的中介作用不显著.在临床实践中,重要的是要考虑MASLD患者的免疫和代谢紊乱。
    BACKGROUND: Existing studies have presented limited and disparate findings on the nexus between immune cells, plasma metabolites, and metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of this study was to investigate the causal relationship between immune cells and MASLD. Additionally, we aimed to identify and quantify the potential mediating role of metabolites.
    METHODS: A Mendelian randomization (MR) analysis was conducted using two samples of pooled data from genome-wide association studies on MASLD that included 2568 patients and 409,613 control individuals. Additionally, a mediated MR study was employed to quantify the metabolite-mediated immune cell effects on MASLD.
    RESULTS: In this study, eight immunophenotypes were linked to the risk of MASLD, and thirty-five metabolites/metabolite ratios were linked to the occurrence of MASLD. Furthermore, a total of six combinations of immunophenotypic and metabolic factors demonstrated effects on the occurrence of MASLD, although the mediating effects of metabolites were not significant.
    CONCLUSIONS: Our study demonstrated that certain immunophenotypes and metabolite/metabolite ratios have independent causal relationships with MASLD. Furthermore, we identified specific metabolites/metabolite ratios that are associated with an increased risk of MASLD. However, their mediating role in the causal association between immunophenotypes and MASLD was not significant. It is important to consider immune and metabolic disorders among patients with MASLD in clinical practice.
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  • 文章类型: Journal Article
    最近将非酒精性脂肪性肝病(NAFLD)重新分类为代谢功能障碍相关的脂肪性肝病(MAFLD)和代谢功能障碍相关的脂肪变性肝病(MASLD)的努力旨在将注意力转移到该疾病的代谢基础上,而不是饮酒。这种重新分类认识到肥胖的作用,久坐的生活方式和不良的饮食习惯在疾病的发展,从而更好地了解其病因。然而,过渡带来了自己的挑战,特别是关于患者和医疗保健专业人员之间的沟通。许多医疗保健专业人员报告难以解释细微差别的概念,尤其是术语“脂肪变性”。此外,术语的改变还没有消除污名,关于“脂肪”和“脂肪”这两个术语是否合适的争论正在进行。调查表明,虽然“肥胖”可能被认为是更多的污名化,医学术语“脂肪变性肝病”不被认为是污名化的,表明医疗保健专业人员和患者之间的观念脱节。
    Recent efforts to reclassify non-alcoholic fatty liver disease (NAFLD) as metabolic dysfunction-associated fatty liver disease (MAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are intended to divert attention to the metabolic basis of the disease rather than to alcohol consumption. This reclassification recognizes the role of obesity, sedentary lifestyles and poor dietary habits in the development of the disease, leading to a better understanding of its etiology. Nevertheless, the transition has posed its own challenges, particularly with regard to communication between patient and healthcare professional. Many healthcare professionals report difficulty in explaining the nuanced concepts, especially the term \"steatosis\". In addition, the change in terminology has not yet removed the stigma, with ongoing debates about the appropriateness of the terms \"fatty\" and \"steatotic\". Surveys suggest that while \"obesity\" may be perceived as more stigmatizing, the medical term \"steatotic liver disease\" is not considered as stigmatizing, indicating a disconnect in perceptions between healthcare professionals and patients.
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  • 文章类型: Journal Article
    随着现代生活的快节奏,人们吃饭的时间更少,但是很少有研究研究过快速饮食习惯与代谢性疾病之间的关联。
    结合当前研究和先前研究的结果,我们旨在探讨快速饮食与代谢功能障碍相关脂肪变性肝病(MASLD)风险之间的可能关系.
    这是对1965名参与者的多中心横断面研究的子分析,调查了中国人快速饮食与MASLD之间的关联。快速进食被定义为用餐时间少于五分钟,参与者根据他们自我报告的快速进食频率分为三类:≤1次/月,≤1次/周且≥2次/周。我们进一步对11月之前发表的可用研究进行了文献检索,2023年以及一项荟萃分析,以调查快速饮食与MASLD之间的关系。
    MASLD的比例为59.3%,50.5%,46.2%的参与者快速进食≥2次/周,≤1次/周,≤1次/月,分别(趋势P<0.001)。在多次调整性别后,快速进食的频率与MASLD的风险独立相关,年龄,人口统计,吸烟和饮酒状况,BMI和临床代谢参数(OR,1.29;95CI,1.09-1.53)。频繁进食(≥2次/周)的参与者发生MASLD的风险高81%(P=0.011)。对五项符合条件的研究进行的荟萃分析证实,频繁的快速进食与MASLD的风险增加有关(汇总OR,1.22;95CI,1.07-1.39)。
    频繁的快速进食与MASLD的风险增加有关。
    With the fast pace of modern life, people have less time for meals, but few studies have examined the association between the habit of fast eating and metabolic diseases.
    Combining the results of the current study and the prior ones, we aimed to investigate the possible relationship between fast eating and the risk of metabolic dysfunction-associated steatotic liver disease (MASLD).
    This is a sub-analysis of a multicenter cross-sectional study of 1965 participants investigated the association between fast eating and MASLD in Chinese. Fast eating was defined as meal time less than five minutes and participants were divided into three categories based on their self-reported frequency of fast eating: ≤1 time/month, ≤1 time/week and ≥2 times/week. We further conducted a literature search for available studies published before November, 2023 as well as a meta-analysis to investigate the association between fast eating and MASLD.
    The proportion of MASLD was 59.3%, 50.5%, and 46.2% in participants with fast eating ≥2 times/week, ≤1 time/week and ≤1 time/month, respectively (P for trend <0.001). The frequency of fast eating was independently associated with risk of MASLD after multiple adjustment for sex, age, demographics, smoking and drinking status, BMI and clinical metabolic parameters (OR, 1.29; 95%CI, 1.09-1.53). Participants who ate fast frequently (≥2 times/week) had 81% higher risk of MASLD (P = 0.011). A meta-analysis of five eligible studies confirmed that frequent fast eating was associated with increased risk of MASLD (pooled OR, 1.22; 95%CI, 1.07-1.39).
    Frequent fast eating was associated with an increased risk of MASLD.
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  • 文章类型: Journal Article
    代谢相关脂肪性肝病(MAFLD)的遗传易感性复杂且特征差。肝脏脂肪含量的遗传背景的准确表征将提供对疾病病因和危险因素因果关系的见解。我们对肝脏脂肪含量的两个非侵入性定义进行了全基因组关联研究(GWAS):16,050名参与者的磁共振成像质子密度脂肪分数(MRI-PDFF)和来自英国(UK)生物库(UKBB)的388,701名参与者的脂肪肝指数(FLI)。遗传力,遗传重叠,并分析了肝脏脂肪含量表型之间的相似性,并在格罗宁根大学医学中心(UMCG)遗传学生命线倡议(UGLI)的10,398名参与者中复制。UKBBMRI-PDFFGWASs的Meta分析显示5个有统计学意义的位点,包括两个含有CREB3L1(rs72910057-T,P=5.40E-09)和GCM1(rs1491489378-T,P=3.16E-09),分别,以及以前报道的三个基因座:PNPLA3,TM6SF2和APOE。UKBB中FLI的GWAS鉴定出196个全基因组重要基因座,其中49个在UGLI中复制,ZPR1(P=3.35E-13)和FTO(P=2.11E-09)中的顶部信号。MRI-PDFF(UKBB)和FLI(UGLI)GWAS结果之间存在统计学上的显着遗传相关性(rg)(rg=0.5276,P=1.45E-03)。新的MRI-PDFF基因信号(CREB3L1和GCM1)在FLIGWAS中复制。我们确定了MRI-PDFF的两个新基因和FLI的49个可复制基因座。尽管MRI-PDFF和FLI之间的肝脂肪含量评估存在差异,发现了一个相当相似的遗传结构。FLI被认为是在人群水平上研究肝脏脂肪含量的一种简单可靠的方法。
    Genetic susceptibility to metabolic associated fatty liver disease (MAFLD) is complex and poorly characterized. Accurate characterization of the genetic background of hepatic fat content would provide insights into disease etiology and causality of risk factors. We performed genome-wide association study (GWAS) on two noninvasive definitions of hepatic fat content: magnetic resonance imaging proton density fat fraction (MRI-PDFF) in 16,050 participants and fatty liver index (FLI) in 388,701 participants from the United Kingdom (UK) Biobank (UKBB). Heritability, genetic overlap, and similarity between hepatic fat content phenotypes were analyzed, and replicated in 10,398 participants from the University Medical Center Groningen (UMCG) Genetics Lifelines Initiative (UGLI). Meta-analysis of GWASs of MRI-PDFF in UKBB revealed five statistically significant loci, including two novel genomic loci harboring CREB3L1 (rs72910057-T, P = 5.40E-09) and GCM1 (rs1491489378-T, P = 3.16E-09), respectively, as well as three previously reported loci: PNPLA3, TM6SF2, and APOE. GWAS of FLI in UKBB identified 196 genome-wide significant loci, of which 49 were replicated in UGLI, with top signals in ZPR1 (P = 3.35E-13) and FTO (P = 2.11E-09). Statistically significant genetic correlation (rg) between MRI-PDFF (UKBB) and FLI (UGLI) GWAS results was found (rg = 0.5276, P = 1.45E-03). Novel MRI-PDFF genetic signals (CREB3L1 and GCM1) were replicated in the FLI GWAS. We identified two novel genes for MRI-PDFF and 49 replicable loci for FLI. Despite a difference in hepatic fat content assessment between MRI-PDFF and FLI, a substantial similar genetic architecture was found. FLI is identified as an easy and reliable approach to study hepatic fat content at the population level.
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  • 文章类型: Journal Article
    由于经济和生活方式的变化,代谢功能障碍相关的脂肪变性肝病(MASLD)的患病率激增。导致重大的健康挑战。以前的报道已经研究了MASLD的动物和细胞模型的建立,突出它们之间的差异。在这项研究中,通过在MASLD中诱导脂肪积累创建细胞模型。用不同浓度的不饱和脂肪酸油酸刺激HepG2细胞(0.125mM,0.25mM,0.5mM,1mM)以模拟MASLD。使用细胞计数试剂盒-8测定评估模型的功效,油红O染色,和脂质含量分析。本研究旨在为MASLD细胞创建一个操作简单的细胞模型。细胞计数试剂盒-8检测结果表明,HepG2细胞的存活依赖于油酸的浓度,GI50为1.875mM。0.5mM和1mM组细胞活力显著低于对照组(P<0.05)。此外,油红O染色和脂质含量分析检查了不同油酸浓度(0.125mM,0.25mM,0.5mM,1mM)对HepG2细胞。0.25mM的脂质含量,0.5mM,1mM组明显高于对照组(P<0.05)。此外,OA组甘油三酯水平明显高于对照组(P<0.05)。
    The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) has surged due to changes in economic and lifestyle patterns, leading to significant health challenges. Previous reports have studied the establishment of animal and cellular models for MASLD, highlighting differences between them. In this study, a cellular model was created by inducing fat accumulation in MASLD. HepG2 cells were stimulated with the unsaturated fatty acid oleic acid at various concentrations (0.125 mM, 0.25 mM, 0.5 mM, 1 mM) to emulate MASLD. The model\'s efficacy was assessed using cell counting kit-8 assays, Oil Red O staining, and lipid content analysis. This study aimed to create a simple-to-operate cellular model for MASLD cells. Results from the cell counting kit-8 assays showed that the survival of HepG2 cells was dependent on the concentration of oleic acid, with a GI50 of 1.875 mM. Cell viability in the 0.5 mM and 1 mM groups were significantly lower than those in the control group (P < 0.05). Furthermore, Oil Red O staining and lipid content analysis examined fat deposition at varying oleic acid concentrations (0.125 mM, 0.25 mM, 0.5 mM, 1 mM) on HepG2 cells. The lipid content of the 0.25 mM, 0.5 mM, and 1 mM groups was significantly higher than that of the control group (P < 0.05). Additionally, triglyceride levels in the OA groups were significantly higher than those in the control group (P < 0.05).
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Case Reports
    先天性胆囊缺失(CAGB)是胆道系统极为罕见的胚胎异常,具有复杂的病因,涉及胚胎发育过程中胆囊形成的失败。临床表现多样;大多数患者无症状,而有些则出现胆绞痛等症状。其临床表现和放射学特征的复杂性使诊断具有挑战性。
    妊娠22周时的胎儿超声检查显示胆囊缺失。在9岁零11个月大的时候,孩子表现出明显的体重增加和异常。腹部超声和磁共振图像显示脂肪肝和胆囊发育不全。肝功能检查显示轻度异常,天冬氨酸转氨酶为67IU/L,丙氨酸转氨酶为44IU/L经过6个月的保肝和降脂治疗,取得了令人满意的治疗反应,肝功能正常化,脂肪肝改善。
    CAGB可能与其他先天性异常有关,尽管孤立的病例并不常见。临床上,它可能表现为非特异性胆道,胃肠,或泌尿症状,模仿各种消化系统疾病,导致误诊。基因测序和深入的胚胎学研究可以阐明病因并提高诊断准确性。
    UNASSIGNED: Congenital absence of the gallbladder (CAGB) is an exceedingly rare embryological anomaly of the biliary system, with a complex etiology involving the failure of gallbladder formation during embryogenesis. Clinical manifestations are diverse; most patients are asymptomatic, while some present with symptoms such as biliary colic. The complexity of its clinical presentation and radiological features renders diagnosis challenging.
    UNASSIGNED: Fetal ultrasound at 22 weeks of gestation revealed an absent gallbladder. At 9 years and 11 months of age, the child exhibited significant weight gain and abnormalities. Abdominal ultrasound and magnetic resonance images demonstrated fatty liver and gallbladder agenesis. Liver function tests indicated mild abnormalities, with aspartate aminotransferase at 67 IU/L and alanine aminotransferase at 44 IU/L. Following 6 months of hepatoprotective and lipid-lowering therapy, a satisfactory treatment response was achieved, with normalization of liver function and improvement in fatty liver.
    UNASSIGNED: CAGB may be associated with other congenital abnormalities, although isolated cases are uncommon. Clinically, it may manifest as nonspecific biliary, gastrointestinal, or urinary symptoms, mimicking various digestive disorders and leading to misdiagnosis. Genetic sequencing and in-depth embryological research may elucidate the etiology and enhance diagnostic accuracy.
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