新型降糖药物在代谢相关脂肪性肝病中的适应证、作用和地位  

Indications,effects and status of new hypoglycemic drugs in metabolic-associated fatty liver disease

作　　者：缪磊 徐静[3] 郑明华[2,4,5] MIAO Lei;XU Jing;ZHENG Minghua(Department of Gastroenterology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China;NAFLD Research Center,Department of Hepatology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China;Department of Endocrinology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China;Institute of Hepatology,Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China;Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院消化内科,浙江温州325000 [2]温州医科大学附属第一医院感染内科,脂肪肝中心,浙江温州325000 [3]温州医科大学附属第二医院育英儿童医院内分泌科,浙江温州325000 [4]温州医科大学肝病研究所,浙江温州325000 [5]浙江省慢性肝病重症化精准诊治与转化重点实验室,浙江温州325000

出　　处：《世界临床药物》2021年第8期619-624,共6页World Clinical Drug

基　　金：国家自然科学基金项目(81500665,82070588);浙江省卫生厅高层次创新人才项目(S2032102600032);温州市新世纪551人才培养项目。

摘　　要：代谢相关脂肪性肝病(MAFLD)是最常见的慢性肝病之一,由其导致的肝硬化和肝细胞癌发病率也在逐年增加。MAFLD的重要危险因素之一就是糖尿病,尤其是2型糖尿病(T2DM),二者互为因果。由于MAFLD的发病机制尚未完全明确,目前仍没有特异性治疗药物。近年来在各种新型降糖药物的临床试验中发现,胰高血糖素样肽-1受体激动剂(GLP-1RAs)、二肽基肽酶-4(DPP-4)抑制剂、钠-葡萄糖共转运体-2(SGLT-2)抑制剂和噻唑烷二酮类(TZDs)等对MAFLD具有减轻肝脏脂肪变性、炎症和纤维化程度的潜力,但尚未被公认。本文就这4类新型降糖药物在MAFLD治疗中的研究进展、作用地位、有效性和安全性等方面进行综述。Metabolic associated fatty liver disease(MAFLD) is one of the most common chronic liver diseases in the world,and the incidence of liver cirrhosis and hepatocellular carcinoma caused by MAFLD has been increasing year by year.One of the most important risk factors of MAFLD is diabetes,especially the type 2 diabetes(T2DM),which interact as cause and effect for each other.Since the pathogenesis of MAFLD has not yet been fully clarified,there is still no specific drug.In recent years,it has been found in clinical trials of various novel hypoglycemic drugs that glucagon-like peptide-1 receptor agonists(GLP-1RAs),dipeptidyl peptidase-4(DPP-4) inhibitors,sodium-glucose symporter-2(SGLT-2) inhibitors and thiazolidinediones(TZDs) have the potential function to reduce liver steatosis,inflammation and fibrosis in MAFLD,but have not been totally recognized.This review discussed the role,status,efficacy and safety of these four novel hypoglycemic drugs in the treatment of MAFLD.

关 键 词：代谢相关脂肪性肝病 非酒精性脂肪性肝炎 2型糖尿病 胰高血糖素样肽-1受体激动剂 二肽基肽酶-4抑制剂 钠-葡萄糖共转运体-2抑制剂 噻唑烷二酮 

分 类 号：R975[医药卫生—药品]