肥胖对肝功能测试的影响:非酒精性脂肪肝是唯一的参与者吗?一篇评论文章。

Porto biomedical journal Pub Date : 2023-10-16 eCollection Date: 2023-09-01 DOI:10.1097/j.pbj.0000000000000228
Mervat M El-Eshmawy
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摘要

目的:肥胖和非酒精性脂肪肝(NAFLD)是世界范围内常见的健康问题,两者之间有着密切的关系。由于肥胖的流行,NAFLD是目前肝功能测试异常(LFT)的最常见原因。问题是NAFLD是肥胖中唯一一个LFT异常的参与者吗?方法:本文通过PubMed对所有英语文献的搜索策略,回顾了肥胖患者LFT紊乱的最重要主题。结果:据报道,肥胖患者的LFT异常表现为血清转氨酶(丙氨酸氨基转移酶、天冬氨酸氨基转移酶)、γ-谷氨酰转移酶和碱性磷酸酶水平升高,血清胆红素和白蛋白水平降低。除了新的潜在的NAFLD/NASH肝脏标志物,如甘油三酯/高密度脂蛋白胆固醇比、性激素结合球蛋白、成纤维细胞生长因子21和肝细胞凋亡标志物,即细胞角蛋白18和微小核糖核酸(miRNA)。除了NAFLD,肥胖中LFT异常还有其他潜在因素,如氧化应激、炎症和胰岛素抵抗。结论:肥胖患者LFT的紊乱可归因于NAFLD,也可归因于肥胖本身及其相关的氧化应激、胰岛素抵抗和慢性炎症状态。LFT异常预测的不仅仅是肝脏疾病。
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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Impact of obesity on liver function tests: is nonalcoholic fatty liver disease the only player? A review article.

Objectives: Obesity and nonalcoholic fatty liver disease (NAFLD) are common worldwide health problems with a strong relationship in between. NAFLD is currently the most common cause of abnormal liver function tests (LFT) because of obesity pandemic. The question is NAFLD the only player of abnormal LFT in obesity?

Methodology: This article reviews the most important topics regarding the derangements of LFT in obesity through a PubMed search strategy for all English-language literature.

Results: The reported abnormal LFT in obesity were increased serum levels of transaminases (alanine aminotransaminase, aspartate aminotransaminase), gamma glutamyl transferase, and alkaline phosphatase and decreased serum levels of bilirubin and albumin. Besides novel potential hepatic markers of NAFLD/NASH such as triglycerides/high-density lipoprotein cholesterol ratio, sex hormone-binding globulin, fibroblast growth factor 21, and markers of hepatocyte apoptosis i.e. cytokeratin 18 and microribonucleic acids (miRNAs). Beyond NAFLD, there are other underlying players for the abnormal LFT in obesity such as oxidative stress, inflammation, and insulin resistance.

Conclusion: Derangements of LFT in obesity are attributed to NAFLD but also to obesity itself and its related oxidative stress, insulin resistance, and chronic inflammatory state. Abnormal LFT predict more than just liver disease.

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