文章摘要

甘油三酯在非酒精性脂肪肝沉积的机制研究进展

作者: 1廖海林, 1肖新华
1 南华大学附属第一医院内分泌科,湖南 衡阳 421001
通讯: 肖新华 Email: dr.xiaoxh@hotmail.com
DOI: 10.3978/j.issn.2095-6959.2014.06.036
基金: 国家自然科学基金, 81270925 湖南省自然科学基金重点项目, 12JJ2050 教育部留学人员归国基金, 2013JYB03

摘要

非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)是一种无过量饮酒史,以肝脏实质细胞脂 肪变性及脂质沉积为特点的最常见的肝脏疾病。目前对NAFLD的研究集中在肝脂肪变性发生的潜 在的病理机制的探索,以及基于这些机制而确定出新的治疗靶点。NAFLD的发生发展与肝血清游 离脂肪酸(free fatty acid,FFA)的摄取、肝内TG从头合成、肝脂肪酸氧化以及肝VLDL分泌之间失 衡密切相关。NAFLD患者由于胰岛素抵抗(insulin resistance,IR),可通过多种机制导致肝脏脂肪 变性。由于肝脏、脂肪组织等胰岛素的反应性降低使脂肪组织脂解作用增加,进而导致肝脏FFA 摄取率的增加。高胰岛素血症促进肝脏脂肪从头合成相关基因转录水平的上调,脂肪酸氧化和 VLDL分泌的速率低于肝脏脂质沉积的速率。本文从肝内TG从头合成(de novo lipogenesis,DNL)、 肝血清FFA的摄取、肝脂肪酸氧化及VLDL分泌四个方面分别阐述肝脏TG代谢平衡的分子机制及IR 时TG的代谢变化,从而阐明TG在NAFLD的沉积的机制。
关键词: 非酒精性脂肪肝 甘油三酯 沉积

Research advance on mechanisms of hepatic triglyceride accumulation in non-alcoholic fatty liver disease

Authors: 1LIAO Hailin, 1XIAO Xinhua
1 Department of Endocrinology, First Affiliated Hospital, University of South China, Hengyang Hunan 421001, China

CorrespondingAuthor: XIAO Xinhua Email: dr.xiaoxh@hotmail.com

DOI: 10.3978/j.issn.2095-6959.2014.06.036

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease which is characterized by hepatic steatosis and accumulation of lipid in the absence of excess alcohol intake. The current researches are focused on understanding the underlying pathobiology of hepatic steatosis which would promote the development of mechanism-based therapeutic interventions. The occurrence and development of NAFLD is closely associated with the unbalance of uptake of free fatty acid (FFA) from the plasma, de novo lipogenesis, fatty acid oxidation and the secretion of VLDL. Insulin resistance in NAFLD leads to hepatic steatosis by multiple mechanisms. Increased release from an expanded mass of adipose tissue account for greater uptake rates of plasma FFA because of reduced hepatic and adipose tissue insulin sensitivity. Hyperinsulinemia upregulate transcriptional genes that are related with de novo lipogenesis in the liver. The rate of hepatic lipid accumulation exceeds fatty acid oxidation and VLDL secretion. From the four aspects mentioned above, this review will separately discuss the molecular mechanisms by which hepatic triglyceride homeostasis is achieved, as well as the TG metabolic alterations that occur in the setting of insulin resistance and contribute to the pathogenesis of accumulation of TG in NAFLD.

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