Hepatic Fibrosis and Cancer: The Silent Threats of Metabolic Syndrome.

IF 6.8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes & Metabolism Journal Pub Date : 2024-03-01 Epub Date: 2024-01-26 DOI:10.4093/dmj.2023.0240
Scott L Friedman
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Abstract

Metabolic dysfunction-associated steatotic (fatty) liver disease (MASLD), previously termed non-alcoholic fatty liver disease, is a worldwide epidemic that can lead to hepatic inflammation, fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). The disease is typically a component of the metabolic syndrome that accompanies obesity, and is often overlooked because the liver manifestations are clinically silent until late-stage disease is present (i.e., cirrhosis). Moreover, Asian populations, including Koreans, have a higher fraction of patients who are lean, yet their illness has the same prognosis or worse than those who are obese. Nonetheless, ongoing injury can lead to hepatic inflammation and ballooning of hepatocytes as classic features. Over time, fibrosis develops following activation of hepatic stellate cells, the liver's main fibrogenic cell type. The disease is usually more advanced in patients with type 2 diabetes mellitus, indicating that all diabetic patients should be screened for liver disease. Although there has been substantial progress in clarifying pathways of injury and fibrosis, there no approved therapies yet, but current research seeks to uncover the pathways driving hepatic inflammation and fibrosis, in hopes of identifying new therapeutic targets. Emerging molecular methods, especially single cell sequencing technologies, are revolutionizing our ability to clarify mechanisms underlying MASLD-associated fibrosis and HCC.

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肝纤维化和癌症:代谢综合征的无声威胁。
代谢功能障碍相关性脂肪性(脂肪)肝病(MASLD),以前称为非酒精性脂肪肝,是一种全球性流行病,可导致肝脏炎症、纤维化、肝硬化和肝细胞癌(HCC)。这种疾病通常是伴随肥胖而来的代谢综合征的一个组成部分,由于肝脏表现在临床上是无声的,直到出现晚期疾病(即肝硬化)时才会被发现,因此常常被忽视。此外,包括韩国人在内的亚洲人群中,瘦弱患者的比例较高,但他们的疾病预后与肥胖患者相同,甚至更差。然而,持续的损伤会导致肝脏炎症和肝细胞气球化,这是典型的特征。随着时间的推移,肝脏的主要纤维化细胞--肝星状细胞被激活后,就会出现纤维化。2 型糖尿病患者的病情通常更为严重,这表明所有糖尿病患者都应接受肝病筛查。虽然在阐明损伤和纤维化的途径方面取得了重大进展,但目前还没有获得批准的疗法,但目前的研究试图揭示驱动肝脏炎症和纤维化的途径,希望能找到新的治疗靶点。新兴的分子方法,尤其是单细胞测序技术,正在彻底改变我们阐明 MASLD 相关纤维化和 HCC 潜在机制的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diabetes & Metabolism Journal
Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
10.40
自引率
6.80%
发文量
92
审稿时长
52 weeks
期刊介绍: The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.
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