肝分泌物在非酒精性脂肪性肝病中的作用。
The role of hepatokines in NAFLD.
机构信息
Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University Hospital of Tübingen, Otfried-Müller Str. 10, 72076 Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Section of Experimental Radiology, Department of Radiology, University Hospital of Tübingen, Tübingen, Germany.
出版信息
Cell Metab. 2023 Feb 7;35(2):236-252. doi: 10.1016/j.cmet.2023.01.006.
Non-alcoholic fatty liver disease (NAFLD) is not only a consequence of insulin resistance, but it is also an important cause of insulin resistance and major non-communicable diseases (NCDs). The close relationship of NAFLD with visceral obesity obscures the role of fatty liver from visceral adiposity as the main pathomechanism of insulin resistance and NCDs. To overcome this limitation, in analogy to the concept of adipokines, in 2008 we introduced the term hepatokines to describe the role of fetuin-A in metabolism. Since then, several other hepatokines were tested for their effects on metabolism. Here we address the dysregulation of hepatokines in people with NAFLD. Then, we discuss pathophysiological mechanisms of cardiometabolic diseases specifically related to NAFLD by focusing on hepatokine-related organ crosstalk. Finally, we propose how the determination of major hepatokines and adipokines can be used for pathomechanism-based clustering of insulin resistance in NAFLD and visceral obesity to better implement precision medicine in clinical practice.
非酒精性脂肪性肝病（NAFLD）不仅是胰岛素抵抗的结果，也是胰岛素抵抗和主要非传染性疾病（NCDs）的重要原因。NAFLD 与内脏肥胖的密切关系掩盖了脂肪肝作为胰岛素抵抗和 NCDs 的主要发病机制的作用。为了克服这一局限性，我们类比脂联素的概念，于 2008 年提出了“肝激素”一词来描述胎球蛋白-A 在代谢中的作用。此后，还测试了其他几种肝激素对代谢的影响。在这里，我们探讨了 NAFLD 患者肝激素的失调。然后，我们通过关注与肝激素相关的器官串扰，讨论了与 NAFLD 相关的特定心脏代谢疾病的病理生理机制。最后，我们提出了如何确定主要的肝激素和脂联素，以便基于发病机制对 NAFLD 和内脏肥胖患者的胰岛素抵抗进行聚类，从而在临床实践中更好地实施精准医学。
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