表观遗传学在瘦型非酒精性脂肪性肝病中的作用及临床应用前景

徐俊姣; 刘素彤; 张琪振; 管雅捷; 崔蓓蕾; 吴文静; 刘鸣昊

doi:10.12449/JCH250624

表观遗传学在瘦型非酒精性脂肪性肝病中的作用及临床应用前景

DOI: 10.12449/JCH250624

徐俊姣^{1, 2},
刘素彤¹,
张琪振^{1, 2},
管雅捷^{1, 2},
崔蓓蕾^{1, 2},
吴文静^{1, 2},
刘鸣昊^{1, 3, 4, 5, , ,}

1.
河南中医药大学第一附属医院脾胃肝胆科，郑州 450000
2.
河南中医药大学第一临床医学院，郑州 450000
3.
中西医防治重大疾病河南省协同创新中心，郑州 450000
4.
豫药全产业链研发河南省协同创新中心，郑州 450000
5.
河南省中医药科学院，郑州 450000

基金项目:

国家自然科学基金 (81904154);

国家自然科学基金 (82205086);

河南省科技攻关计划 (242102310500);

河南省“双一流”创建学科中医学科学研究专项 (HSRP-DFCTCM-2023-1-10)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：徐俊姣负责起草和撰写论文；刘素彤负责设计并讨论文章框架；张琪振、管雅捷、崔蓓蕾、吴文静负责关键内容的修改；刘鸣昊负责指导撰写文章并最后定稿。

详细信息

通信作者:
刘鸣昊， liumh015@163.com （ORCID： 0009-0001-7712-4605）

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出版历程
- 收稿日期: 2024-09-20
- 录用日期: 2024-10-11
- 出版日期: 2025-06-25

Role and clinical application prospect of epigenetics in lean nonalcoholic fatty liver disease

Junjiao XU^{1, 2},
Sutong LIU¹,
Qizhen ZHANG^{1, 2},
Yajie GUAN^{1, 2},
Beilei CUI^{1, 2},
Wenjing WU^{1, 2},
Minghao LIU^{1, 3, 4, 5
, ,
,}

1.
Department of Spleen，Stomach，Liver and Gallbladder，The First Affiliated Hospital of Henan University of Traditional Chinese Medicine，Zhengzhou 450000，China
2.
The First Clinical Medical College of Henan University of Chinese Medicine，Zhengzhou 450000，China
3.
Collaborative Innovation Center of Prevention and Treatment of Major Diseases by Chinese and Western Medicine，Henan Province，Zhengzhou 450000，China
4.
Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao，Henan Province，Zhengzhou 450000，China
5.
Henan Academy of Traditional Chinese Medicine，Zhengzhou 450000，China

Research funding:

National Natural Science Foundation of China (81904154);

National Natural Science Foundation of China (82205086);

Science and Technology Key Project of Henan Province (242102310500);

Special Research Project for Traditional Chinese Medicine Science in Henan Province’s “Double First Class” Creation Discipline (HSRP-DFCTCM-2023-1-10)

More Information

Corresponding author: LIU Minghao， liumh015@163.com （ORCID： 0009-0001-7712-4605）

摘要

摘要: 表观遗传学机制在非酒精性脂肪性肝病（NAFLD）的发生、发展中扮演着至关重要的角色，尤其是在瘦人群体中，相关表观遗传学机制的研究为揭示NAFLD的潜在病因和治疗策略提供了新的线索和方向。本文介绍了近年表观遗传学在瘦型NAFLD发展中的作用，分析了瘦型NAFLD表观遗传学方面的最新研究进展，简述了表观遗传学的基本概念，包括DNA甲基化、组蛋白修饰和非编码RNA调控，并探讨了表观遗传学改变如何影响瘦型NAFLD的发病机制、疾病进展以及治疗策略。
- 非酒精性脂肪性肝病 /
- 表观基因组学 /
- 病理过程
Abstract: Epigenetic mechanisms play a crucial role in the development and progression of nonalcoholic fatty liver disease （NAFLD）， especially among lean individuals. The research on related epigenetic mechanisms has provided new clues and directions for revealing the underlying causes and treatment strategies of NAFLD. This article introduces the role of epigenetics in the development and progression of NAFLD among lean individuals in recent years， analyzes the latest research advances in the epigenetics of NAFLD in this population， and briefly describes the basic concepts of epigenetics， including DNA methylation， histone modifications， and non-coding RNA regulation. This article also discusses how epigenetic alterations impact the pathogenesis， disease progression， and treatment strategies of NAFLD in lean individuals.
- Non-alcoholic Fatty Liver Disease /
- Epigenomics /
- Pathologic Processes

HTML全文

图 1 表观遗传学改变脂质代谢和炎症反应的机制

Figure 1. Epigenetic changes in lipid metabolism and inflammatory response mechanisms diagram

下载: 全尺寸图片幻灯片

表 1 非瘦型NAFLD与瘦型NAFLD两种分型的区别

Table 1. The difference between the two types of non-lean NAFLD and lean NAFLD

项目	非瘦型NAFLD	瘦型NAFLD 1型	瘦型NAFLD 2型
BMI（亚洲人群标准）	>27.5 kg/m²	<23 kg/m²，但以腰围或其他身体成分可能衡量为肥胖	BMI处于瘦人范畴，且无内脏肥胖
主要发病机制	胰岛素抵抗和脂肪代谢紊乱、氧化应激和脂质过氧化、炎症反应和免疫失调、肠道菌群失调	内脏肥胖和胰岛素抵抗	单基因疾病导致
主要病理改变	单纯脂肪肝：肝细胞大量脂滴积累，无明显肝细胞损伤；NASH：肝细胞明显损伤和炎细胞浸润；肝纤维化和肝硬化：肝细胞正常结构严重破坏，假小叶形成，伴有广泛肝纤维化	脂肪变性、（严重）代谢异常：血脂异常、空腹血糖上升等，易出现炎症和肝纤维化，进而发展为肝硬化	脂肪变性（较1型轻）、代谢异常（较1型轻）：血脂异常、空腹血糖上升等，遗传基因变异

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