BMJ :脂肪肝更易诱发糖尿病、高血脂和高血压等心脏代谢疾病!

2020-07-28 探索菌 生物探索

脂肪肝 ,也称肝脂肪,是由于各种原因引起的肝细胞内脂肪堆积过多的病变。随着现代人生活水平的提高,熬夜、嗜酒、高脂饮食和过度减肥等因素均会导致肝脏中的脂肪超标(5%~10%),最终发展为肝硬化和肝癌。

脂肪肝 (fatty liver) ,也称肝脂肪,是由于各种原因引起的肝细胞内脂肪堆积过多的病变。简单来讲,肝脏本身需要贮备少量脂肪以备不时之需,而随着现代人生活水平的提高,熬夜、嗜酒、高脂饮食和过度减肥等因素均会导致肝脏中的脂肪超标(5%~10%),造成肝细胞“变形”、转氨酶升高,并最终发展为肝硬化和肝癌。

早前的研究发现,心脏代谢疾病(CMD) 通常与胰岛素抵抗(IR,对胰岛素的敏感能力下降)、血脂异常和高血压密切相关。近日,《BMJ》的最新一项研究发现:青少年的肥胖和心脏代谢功能障碍有关,与腹部脂肪相比,肝脂肪与心脏代谢功能异常的关联更为密切。这个发现具有重大意义,意味着有望将与脂肪肝相关的“靶点”作为肥胖的早期筛查或治疗手段。

为了更清楚地比较肝脂肪、腹部脂肪和皮下脂肪与心脏代谢疾病(CMD) 的关系,研究人员使用了一些生物标记物对耶鲁283名儿童和青少年的肝脏脂肪、腹部脂肪和皮下脂肪进行了分析。令研究者意外的是,与其他因素相比,肝脂肪与心脏代谢功能障碍的关联更为密切,同时对胰岛素会更加的不敏感。

这意味着,与健康人相比,有脂肪肝的人更容易患一些高血脂、高血压和动脉粥样硬化等心脏代谢类疾病[3],同时也会更容易发生胰岛素抵抗 (IR)。如果将胰岛素比作钥匙,IR则意味着这把钥匙在转化为葡萄糖给身体蓄能的过程中“失灵”,结果导致大量的葡萄糖积聚在血液中,逐渐发展为糖尿病[4]。

脂肪肝不仅与肥胖密切相关,还是心脏代谢疾病的最关键的因素。看来,脂肪肝的“威力”不容小觑。然而,目前市面上尚无治疗脂肪肝的特效药。那么,面对脂肪肝的重大威胁,我们需要怎么做?

首先做好预防措施,从源头上杜绝肝上的“脂肪超标”。脂肪肝虽然不怕药物,但是最怕的是运动和饮食。只要有规律地运动(每周三次,每次至少30分钟),再加上营养均衡的适度饮食(削减糖果甜食、精制谷物、动物脂肪,并以蔬菜、水果、全谷物等食物为主)、少食多餐以及不过度饮酒,脂肪肝将会“远离”我们。

其次,脂肪肝患者也不用担心,科学家已经开发出非酒精性脂肪肝新疗法,利用人工合成的非熊去氧胆酸(nor-urso) 来帮助改善患者的预后以及生活质量,个体化治疗脂肪肝的方案也会逐步得到完善和应用。

总之,在疾病面前,我们无需畏惧。因为我们有“抵御癌症”的终极法宝:“预防和治疗双管齐下”的原则和“科学持续进步”的信念。

原始出处:

Catherine E Cioffi 1, K M Venkat Narayan 2, Ken Liu 3, et al.Hepatic fat is a stronger correlate of key clinical and molecular abnormalities than visceral and abdominal subcutaneous fat in youth.BMJ Open Diabetes Res Care. 2020 Jul;8(1):e001126. doi: 10.1136/bmjdrc-2019-001126.

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    2020-08-22 gaoxiaoe
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    2020-07-30 freve
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    2020-07-28 misszhang

    谢谢MedSci提供最新的资讯

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Psychoneuroendocrinology :有糖尿病的人减压有降糖功效!

皮质醇被称为人体压力激素。着急、生气都会导致皮质醇水平升高。近期,《心理神经内分泌学》发表的一项研究提示,皮质醇对2型糖尿病患者有害,与多年来空腹血糖水平升高有关。