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酒精性肝病(alcoholic liver disease,ALD)位居世界发病率和死亡率前列。肝脏脂肪的蓄积为ALD发生的最初特征。近年的研究提示脂肪变性不仅在ALD始发中起作用,在ALD进展中也起着关键作用。患有脂肪肝的病人更容易发展成酒精性肝硬化。如何预防和逆转ALD目前尚缺乏有效措施。由于肝胰岛素抵抗与脂肪肝以及脂肪性肝炎的发生显著相关,目前已有动物实验表明二甲双胍可用于治疗非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)以及非酒精性脂肪性肝炎。由于NAFLD的自然史与ALD相似,病理机制有类似之处,因此,理论上二甲双胍有可能用于ALD的治疗。为了验证这一假说,美国密歇根州立大学的Bergheim Ina等学者采用小鼠酒精暴露诱导ALD模型,证实了二甲双胍可以有效预防酒精诱导的肝损害,研究结果发表于近期的《胃肠病学》杂志(Gastroenterology,2006,130:2099- 2112)。
Alcoholic liver disease (ALD) is at the forefront of world morbidity and mortality. The accumulation of liver fat is the first sign of ALD. Recent studies suggest that steatosis not only plays a role in the onset of ALD, but also plays a key role in the progression of ALD. Patients with fatty liver are more likely to develop alcoholic cirrhosis. How to prevent and reverse ALD is still lack of effective measures. Since hepatic insulin resistance is significantly associated with fatty liver and steatohepatitis, animal experiments have shown that metformin can be used to treat nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis. Since the natural history of NAFLD is similar to that of ALD, there are similarities in the pathogenesis, so it is theoretically possible that metformin may be used in the treatment of ALD. In order to test this hypothesis, Bergheim Ina, Michigan State University and other scholars using mouse alcohol exposure induced ALD model, confirmed that metformin can effectively prevent alcohol-induced liver damage, the results published in the recent “Gastroenterology” magazine ( Gastroenterology, 2006, 130: 2099-2122).