高尿酸血症与脂肪堆积相互作用的研究进展  

Research progress on the interaction between hyperuricemia and lipid accumulation

作　　者：王煜颖 叶菲[1] 李雪晨[1] Wang Yuying;Ye Fei;Li Xuechen(Institute of Materia Medica,Chinese Academy of Medical Science&Peking Union Medical College,Beijing100050,China)

机构地区：[1]中国医学科学院,北京协和医学院药物研究所,北京100050

出　　处：《中华临床营养杂志》2024年第6期378-384,共7页Chinese Journal of Clinical Nutrition

基　　金：国家自然科学基金青年科学基金项目(22107121,82000820)。

摘　　要：随着生活方式及饮食结构的改变、社会经济水平的提高,高尿酸血症(hyperuricemia,HUA)和肥胖患病率呈上升趋势。HUA与脂肪堆积密切相关,两者互为独立风险因素。HUA通过促进氧化应激或诱导糖代谢异常,最终导致脂肪堆积。HUA诱导脂肪堆积涉及的机制包括,促炎因子生成增加、线粒体氧化应激、诱导果糖代谢和ChREBP激活。尿酸的生成与排泄失衡是HUA发生发展的根本原因。脂肪堆积通过使尿酸生成增多或使尿酸排泄减少,升高血尿酸水平,诱导HUA的发生。脂肪堆积诱导HUA涉及的机制包括肾小球滤过减少、尿酸重吸收减少、尿酸生成相关酶活性增加与尿酸生成底物浓度增加。文中阐述了HUA和脂肪堆积互相促进的机制,为HUA合并肥胖、脂肪肝等疾病的合理用药提供理论支持,为相关新药研发提供思路。Along with the evolution in lifestyle and dietary structure and improvement in socioeconomic level,there has been an increase in the prevalence rate of hyperuricemia(HUA)and obesity.HUA is closely related with lipid accumulation and both are independent risk factors for one another.HUA induces lipid accumulation through oxidative stress and glucose metabolism dysfunction.The mechanisms involved in HUA-induced lipid accumulation include increasing pro-inflammatory factors,mitochondrial oxidative stress,inducing fructose metabolism and activating ChREBP.The imbalance between uric acid production and excretion is the root cause of HUA.Lipid accumulation impacts both the production and the excretion of uric acid,thus elevating serum uric acid level and eliciting HUA.The mechanisms by which lipid accumulation induces HUA include reducing glomerular filtration,decreasing uric acid reabsorption,increasing enzyme activity related to uric acid production and increasing concentration of substrates for uric acid synthesis.Here,we reviewed the mutual promoting mechanisms between HUA and lipid accumulation,which may provide atheoretical support for rational drug use in HUA combined with obesity or fatty liver disease and inform relative innovative drug development.

关 键 词：高尿酸血症 脂肪堆积 胰岛素抵抗 氧化应激 

分 类 号：R589.7[医药卫生—内分泌]