中国科学技术大学学报 ›› 2018, Vol. 48 ›› Issue (10): 777-780.DOI: 10.3969/j.issn.0253-2778.2018.10.001

• 原创论文 •    下一篇

非酒精性脂肪肝:2型糖尿病发病的始动环节?

翁建平   

  1. 1.中国科学技术大学生命科学与医学部, 附属第一医院(安徽省立医院)内分泌科,安徽合肥230001; 2. 南京大学医学院附属鼓楼医院内分泌科,江苏南京210008;3.大连医科大学, 辽宁大连116044
  • 收稿日期:2018-09-06 修回日期:2018-09-20 出版日期:2018-10-31 发布日期:2018-10-31
  • 通讯作者: 翁建平
  • 作者简介:翁建平(通讯作者),教授,主任医师,中国科学技术大学临床医学院执行院长、附属第一医院副院长.教育部“长江学者特聘教授”,国家杰出青年科学基金获得者.2007年获聘中山大学二级教授、一级主任医师;中山大学首批中山名医之一,国家重点学科首任学科带头人(2007年~).兼任《中华糖尿病杂志》总编辑、《中华医学杂志(英文版)》 副总编辑、《British Medical Journal》顾问编委、《Diabetes/Metabolism Research and Reviews》联合主编、《Journal of Diabetes》及《Journal of Diabetes Investigation》副主编、中华医学会糖尿病学分会主任委员(2013~2015年).2011年以“2型糖尿病新治疗方案研究与临床应用”获国家科学技术进步奖二等奖(第一完成人);代表中华医学会糖尿病学分会首次发布“Standard Care of Type 2 Diabetes in China”.亚洲分子糖尿病研究会副理事长(2008年~),卡塔尔国家WISH基金会创始成员.从事糖尿病、脂肪肝、血脂异常、肥胖等内分泌代谢性疾病临床、基础及转化医学研究.E-mail:wengjp@ustc.edu.cn
  • 基金资助:
    国家重点研发计划(2016YFC1304801)资助.

Non-alcoholic fatty liver disease: a starting point of the onset of type 2 diabetes mellitus?

WENG Jianping   

  1. 1. Department of Endocrinology,The First Affiliated Hospital of USTC(Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; 2. Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China; 3. Dalian Medical University, Dalian 116044, China
  • Received:2018-09-06 Revised:2018-09-20 Online:2018-10-31 Published:2018-10-31

摘要: 随着人们生活方式的改变,非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)已为我国最常见的肝脏疾病.作为代谢性疾病,NAFLD与2型糖尿病(type 2 diabetes mellitus,T2DM)发病密切相关.NAFLD患者的T2DM发病风险增加近5倍,被认为是T2DM发病的独立危险因素.因此,深入认识NAFLD与T2DM的关系有助于我们重新认识T2DM的发病机制,为制定T2DM防治措施提供依据.本文从肝脏脂代谢紊乱导致胰岛素抵抗、炎性因子释放增加、影响机体整体代谢、损失胰岛β细胞功能、影响肠促胰岛素分泌和降低脂肪组织胰岛素敏感性等几个方面,探讨NAFLD在促发T2DM中的始动作用.

关键词: β细胞功能, 肠促胰岛素样肽-1, 炎症, 胰岛素抵抗, 脂代谢, 非酒精性脂肪肝, 2型糖尿病

Abstract: With changes in lifestyle, non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease. As metabolic diseases, NAFLD is strongly associated with type 2 diabetes mellitus (T2DM). An individual’s risk of developing diabetes is increased approximately 5-fold if they have NAFLD. Numerous studies suggest that NAFLD has a causal role in the onset of T2DM.Therefore, unraveling the relationship between lipid metabolism disturbance and T2DM contributes to the understanding of the etiology of T2DM and the intervention of T2DM.This paper reviewed the mechanisms underlying the pathogenesis of T2DM by NAFLD such as insulin resistance, increased inflammatory mediator release, induction of metabolic dysfunction by hepatokines, impaired β-cell function, influence on incretin by liver and decreased insulin sensitivity in adipose tissue.

Key words: β-cell function, glucagon-like peptide-1, inflammation, insulin resistance, lipid metabolism, non-alcoholic fatty liver disease, type 2 diabetes mellitus