特定膳食生物活性物质干预代谢功能障碍相关脂肪性肝病的机制研究进展

The Potential and Mechanisms of Dietary Bioactive Substances in the Prevention and Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease

摘要:

代谢功能障碍相关脂肪性肝病(Metabolic Dysfunction-Associated Steatotic Liver Disease, MASLD)已成为全球最主要的慢性肝病,其发病率的持续攀升对全球公共卫生系统构成了严峻挑战。MASLD与肥胖、2型糖尿病等代谢综合征密切相关,其病理进展可从单纯性脂肪变性演变为脂肪性肝炎、肝纤维化,甚至肝硬化和肝细胞癌。鉴于目前特效批准药物非常少,通过生活方式干预,特别是调整膳食结构,进行早期预防和管理显得至关重要。“药食同源”的理念为我们提供了新的视角,即利用日常膳食中富含的生物活性物质来干预MASLD的发生发展。本综述旨在系统性地总结近年来关于膳食来源生物活性物质,包括多酚类、膳食纤维与益生元、不饱和脂肪酸、磷脂与胆碱及其他化合物,在防治MASLD中的作用潜力与分子机制,并探讨其在应用中面临的生物利用度、剂量效应关系等挑战,最后对未来功能性食品的开发方向进行展望。

Abstract:

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most prevalent chronic liver disease worldwide. Its continuously rising incidence poses a severe challenge to global public health systems. MASLD is closely associated with metabolic syndromes such as obesity and type 2 diabetes. Its pathological progression can evolve from simple steatosis to steatohepatitis, liver fibrosis, and even cirrhosis and hepatocellular carcinoma. Given the current scarcity of specifically approved drugs, lifestyle interventions, particularly dietary modification, are crucial for early prevention and management. The concept of "food as medicine" provides a new perspective, suggesting the use of bioactive substances abundant in daily diets to intervene in the onset and progression of MASLD. This review aims to systematically summarize recent research on the potential and molecular mechanisms of dietary-derived bioactive substances—including polyphenols, dietary fibers and prebiotics, unsaturated fatty acids, phospholipids and choline, and other compounds—in preventing and treating MASLD. It also discusses challenges in their application, such as bioavailability and dose-response relationships, and finally offers perspectives on future directions for functional food development.