胰島素阻抗對代謝症候群與脂肪肝之影響

Effects of Insulin Resistance on Metabolic Syndrome and Fatty Liver Disease

陳杰(Chieh Chen)

《北市醫學雜誌》 預刊文章 Pp. 1-8

https://doi.org/10.6200/TCMJ.202201/PP.0037

摘要

全身性胰島素阻抗促進了游離脂肪酸的增加，增加內臟脂肪組織進入肝臟並增加肝臟脂肪生成，這導致脂肪肝和更多的肝臟的胰島素阻抗性（IR）發展；因此過重或肥胖導致的胰島素阻抗性是代謝相關脂肪肝疾病（MAFLD）最大的風險；此外，血脂代謝異常和心血管疾病風險增加的患者的肝臟可能作為一個活躍的內分泌和旁分泌器官，釋放多種生物活性物質，加重全身以及肝臟的胰島素阻抗性，並誘發低度發炎反應，與動脈粥樣性硬化具有很強的關聯，這些患者可能死於肝臟相關併發症，例如：肝硬化和肝細胞癌。

關鍵字

腹部肥胖 ； 代謝症候群 ； 胰島素阻抗症候群 ； 代謝相關性脂肪肝 ； 非酒精性脂肪肝炎

並列摘要

Systemic insulin resistance promotes an increase of free fatty acids and visceral adipose tissue entry into the liver and hepatic lipogenesis, which leads to the development of fatty liver and more hepatic insulin resistance (IR). Thus, insulin resistance caused by overweight or obesity is the most significant risk of metabolic-associated fatty liver disease (MAFLD). In addition, the liver, which acts as an active endocrine and paracrine organ in patients with dyslipidemia and an increased risk of cardiovascular disease, releases various bioactive substances that aggravate systemic and hepatic insulin resistance and induce low-grade inflammation that is strongly associated with atherosclerosis. These patients may die from liver-related complications such as cirrhosis and hepatocellular carcinoma.

並列關鍵字

central obesity ； metabolic syndrome (MetS) ； insulin resistance syndrome (IRS) ； nonalcoholic fatty liver disease (NAFLD) ； nonalcoholic steatohepatitis (NASH)