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代谢功能障碍相关脂肪性肝病最具潜力的新型药物选择

曹海霞 周灿 曾静

内科理论与实践2026,Vol.21Issue(2):113-118,6.
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内科理论与实践2026,Vol.21Issue(2):113-118,6.DOI:10.16138/j.1673-6087.2026.02.02

代谢功能障碍相关脂肪性肝病最具潜力的新型药物选择

The most promising novel drug options for metabolic dysfunction-associated steatotic liver disease

曹海霞 1周灿 1曾静1

作者信息

  • 1. 上海交通大学医学院附属新华医院消化内科,上海 200092
  • 折叠

摘要

Abstract

Metabolic dysfunction-associated steatotic liver disease(MASLD)has become one of the most common chronic liver diseases worldwide.Its progressive phenotype,metabolic dysfunction-associated steatohepatitis(MASH),can further progress to liver fibrosis,cirrhosis,and even hepatocellular carcinoma,and is closely associated with obesity,type 2 diabetes mellitus,chronic kidney diseases,and cardiovascular diseases.Lifestyle intervention remains the cornerstone of MASLD management.However,for patients with active hepatitis and moderate-to-severe fibrosis,pharmacotherapy has become an important complement to alter the disease course.In recent years,the selective thyroid hormone receptor-β agonist resmetirom and the glucagon-like peptide-1 receptor agonist semaglutide have been approved by the U.S.Food and Drug Administration(FDA)for the treatment of non-cirrhotic MASH with moderate-to-severe fibrosis in adults,marking the entry of MASH pharmacotherapy into the stage of evidence-based treatment.Meanwhile,dual or multi-incretin agonists,peroxisome proliferator-activated receptor agonists,fibroblast growth factor 21 analogues,inhibitors of hepatic de novo lipogenesis,and genetically targeted therapies are also showing important promise.Future pharmacotherapy for MASLD should focus not only on promoting MASH resolution and fibrosis improvement,but also on achieving hepatic benefits and integrated control of cardiovascular-renal-hepatic-metabolic risks.For the stage of MASH cirrhosis,its specific pathological mechanisms,effective endpoint setting and generalizable therapeutic strategies still require further breakthroughs.

关键词

代谢功能障碍相关脂肪性肝病/代谢功能障碍相关脂肪性肝炎/肝纤维化/药物治疗/精准分层

Key words

metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis/liver fibrosis/pharmacotherapy/precision stratification

分类

医药卫生

引用本文复制引用

曹海霞,周灿,曾静..代谢功能障碍相关脂肪性肝病最具潜力的新型药物选择[J].内科理论与实践,2026,21(2):113-118,6.

基金项目

上海浦江计划(2024PJD084) (2024PJD084)

交大护理研究重点项目:国内非酒精性脂肪肝专科护士核心能力评价指标体系的构建研究(Jyhz2430) (Jyhz2430)

内科理论与实践

1673-6087

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