代谢相关脂肪性肝病:全身代谢性紊乱的核心枢纽之一OA北大核心

The prevalence rate of metabolic associated fatty liver disease(MAFLD)is steadily increasing worldwide,and MAFLD is now considered a significant risk factor for a wide range of metabolic comorbidities.However,current clinical management strategies often address MAFLD from a single-disease perspective,lacking a comprehensive understanding of the central role and systemic impact of MAFLD in the prevention and control of metabolic comorbidities.This article reviews the current evidence supporting MASLD as both a trigger and a key node in systemic metabolic dysfunction and elaborates on how hepatic insulin resistance,lipotoxic injury,inflammatory responses,and dysregulation of hepatokines mediate organ-specific metabolic disorders including cardiovascular disease,chronic kidney disease,and diabetes.With reference to the latest national and international guidelines,this article proposes an integrated multidisciplinary management strategy,including liver-glucose joint intervention and a cross-organ"cardio-renal-hepatic"strategy,and it also advocates for a paradigm shift from conventional liver-focused management toward liver-centered systemic metabolic control,in order to effectively delay the progression of MAFLD and its related multisystem complications.