膳食模式干预对代谢相关脂肪性肝病的影响与机制研究进展

doi:10.3969/j.issn.1674-8115.2025.07.015

上海交通大学学报（医学版） ›› 2025, Vol. 45 ›› Issue (7): 926-933.doi: 10.3969/j.issn.1674-8115.2025.07.015

膳食模式干预对代谢相关脂肪性肝病的影响与机制研究进展

宋静¹, 姜烁², 万方煜³^,⁴, 李娟¹, 艾迪娜·木合塔³^,⁴, 闵新颖², 周婧琪²()

^1.上海交通大学医学院附属仁济医院临床医学院，上海 200127
^2.上海交通大学公共卫生学院，上海 200025
^3.上海交通大学医学院附属新华医院临床医学院，上海 200092
^4.上海交通大学医学技术学院，上海 200025

收稿日期:2024-09-30 接受日期:2025-03-13 出版日期:2025-07-28 发布日期:2025-07-14
通讯作者: 周婧琪，副研究员，博士；电子信箱：jingqizhou@sjtu.edu.cn。
基金资助:
上海市浦江人才计划(22PJD034);上海交通大学青年人才培育计划(2022QN028)

Research progress in effects and mechanisms of dietary pattern interventions in metabolic associated fatty liver disease

SONG Jing¹, JIANG Shuo², WAN Fangyu³^,⁴, LI Juan¹, MUHETA Adina³^,⁴, MIN Xinying², ZHOU Jingqi²()

^1.Clinical Medical College, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
^2.Shanghai Jiao Tong University School of Public Health, Shanghai 200025, China
^3.Clinical Medical College, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
^4.College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2024-09-30 Accepted:2025-03-13 Online:2025-07-28 Published:2025-07-14
Contact: ZHOU Jingqi, E-mail: jingqizhou@sjtu.edu.cn.
Supported by:
Shanghai Pujiang Program(22PJD034);Youth Talent Training Program of Shanghai Jiao Tong University(2022QN028)

摘要/Abstract

摘要：

代谢相关脂肪性肝病（metabolic associated fatty liver disease，MAFLD）是一种与全身代谢紊乱相关的脂肪性肝病，其患病率逐年攀升，已成为全球公共卫生的重大挑战。MAFLD的发生与肥胖、血脂异常、糖尿病等多种因素相关：体内过多脂肪堆积，尤其是内脏脂肪增加，会使肝脏脂肪积聚；血脂异常也会扰乱肝脏脂肪代谢；糖尿病患者因胰岛素抵抗等问题，患MAFLD风险大增。饮食干预被认为是预防和治疗MAFLD的有效手段。近年来，低碳水化合物饮食、间歇性禁食和地中海饮食等膳食模式已被应用于临床实践。其主要作用机制包括减少氧化应激、调控肠道菌群以及诱导脂肪自噬等。然而，不同个体基因、生活方式及疾病程度的差异导致其对不同饮食模式的反应各异。因此，系统评估这些饮食模式在MAFLD防治中的效果及机制具有重要的临床意义。该文通过比较不同膳食模式在改善肝功能、肝脏脂肪含量、血糖及血脂等方面的效果，分析其潜在干预机制，探讨如何根据个体差异选择个性化饮食策略，为MAFLD的精准防治提供新思路，助力改善患者预后，减轻公共卫生负担。

Abstract:

Metabolic associated fatty liver disease (MAFLD) is a type of fatty liver disease associated with systemic metabolic disorders, and its prevalence has been increasing year by year, becoming a major challenge to global public health. The development of MAFLD is associated with various factors, including obesity, dyslipidemia, diabetes and other factors. Excessive body fat, particularly increased visceral adiposity, contributes to hepatic fat accumulation. Abnormal blood lipid levels can also disrupt liver fat metabolism. The risk of MAFLD in patients with diabetes is greatly increased due to insulin resistance and other problems. Dietary interventions are considered an effective strategy for the prevention and treatment of MAFLD. In recent years, several dietary patterns, such as low-carbohydrate diets, intermittent fasting, and the Mediterranean diet, have been applied in clinical practice. Their primary mechanisms include reducing oxidative stress, regulating gut microbiota, and inducing fat autophagy. However, the responses to different dietary patterns vary among individuals due to differences in genes, lifestyle, and disease severity. Therefore, systematically evaluating the effects and mechanisms of these dietary patterns in the prevention and treatment of MAFLD has significant clinical importance. This review compares the effects of different dietary patterns on improving liver function, hepatic fat content, blood glucose, and lipid levels, and analyzes their underlying mechanisms of intervention, to explore how to select personalized dietary strategies based on individual differences. It is intended to provide new insights for the precise prevention and treatment of MAFLD, thereby improving patients′ outcomes and alleviating the burden on public health.

Key words: metabolic associated fatty liver disease (MAFLD), dietary pattern, dietary intervention, non-alcoholic fatty liver disease (NAFLD)

中图分类号:

R575.5

宋静, 姜烁, 万方煜, 李娟, 艾迪娜·木合塔, 闵新颖, 周婧琪. 膳食模式干预对代谢相关脂肪性肝病的影响与机制研究进展[J]. 上海交通大学学报（医学版）, 2025, 45(7): 926-933.

SONG Jing, JIANG Shuo, WAN Fangyu, LI Juan, MUHETA Adina, MIN Xinying, ZHOU Jingqi. Research progress in effects and mechanisms of dietary pattern interventions in metabolic associated fatty liver disease[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(7): 926-933.

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膳食模式干预对代谢相关脂肪性肝病的影响与机制研究进展

Research progress in effects and mechanisms of dietary pattern interventions in metabolic associated fatty liver disease

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