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首页> 外文期刊>International Journal of Hepatology >Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease
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Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease

机译：非酒精性脂肪肝疾病的多学科药物治疗选择

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Nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are multidisciplinary liver diseases that often accompany type 2 diabetes or metabolic syndrome, which are characterized by insulin resistance. Therefore, effective treatment of type 2 diabetes and metabolic syndrome should target not only the cardiometabolic abnormalities, but also the associated liver disorders. In the last decade, it has been shown that metformin, thiazolidinediones, vitamin E, ezetimibe, n-3 polyunsaturated fatty acids, renin-angiotensin system (RAS) blockers, and antiobesity drugs may improve hepatic pathophysiological disorders as well as clinical parameters. Accordingly, insulin sensitizers, antioxidative agents, Niemann-Pick C1-like 1 (NPC1L1) inhibitors, RAS blockers, and drugs that target the central nervous system may represent candidate pharmacotherapies for NAFLD and possibly NASH. However, the efficacy, safety, and tolerability of long-term treatment (potentially for many years) with these drugs have not been fully established. Furthermore, clinical trials have not comprehensively examined the efficacy of lipid-lowering drugs (i.e., statins, fibrates, and NPC1L1 inhibitors) for the treatment of NAFLD. Although clinical evidence for RAS blockers and incretin-based agents (GLP-1 analogs and dipeptidyl peptidase-4 inhibitors) is also lacking, these agents are promising in terms of their insulin-sensitizing and anti-inflammatory effects without causing weight gain.
机译：非酒精性脂肪肝疾病（NAFLD）和非酒精性脂肪性肝炎（NASH）是多学科肝脏疾病，通常伴随2型糖尿病或代谢综合征，其特征在于胰岛素抵抗。因此，有效治疗2型糖尿病和代谢综合征不仅应针对心脏代谢异常，而且应针对相关的肝脏疾病。在过去的十年中，已证明二甲双胍，噻唑烷二酮，维生素E，依泽替米贝，n-3多不饱和脂肪酸，肾素-血管紧张素系统（RAS）阻滞剂和抗肥胖药可以改善肝脏病理生理疾病以及临床指标。因此，胰岛素增敏剂，抗氧化剂，Niemann-Pick C1样1（NPC1L1）抑制剂，RAS阻滞剂和靶向中枢神经系统的药物可能代表了NAFLD和NASH的候选药物疗法。但是，用这些药物进行长期治疗（可能多年）的疗效，安全性和耐受性尚未完全确定。此外，临床试验还没有全面检查降脂药（他汀类，贝特类和NPC1L1抑制剂）治疗NAFLD的功效。尽管也缺少RAS阻滞剂和基于肠降血糖素的药物（GLP-1类似物和二肽基肽酶4抑制剂）的临床证据，但是这些药物在不引起体重增加的胰岛素敏感性和抗炎作用方面很有前途。

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