运动干预对代谢功能障碍相关脂肪性肝病患者的影响

The Impact of Exercise Intervention on Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease

摘要: 代谢功能障碍相关脂肪性肝病(MASLD)已成为全球健康的重要威胁，其发病率在全球范围内高达30%。MASLD涵盖了一系列表型，从单纯脂肪变性(以肝细胞内脂质积累超过5%为特征)到代谢功能障碍相关脂肪性肝炎(MASH)，后者伴随有肝脏炎症和/或纤维化，进一步可能发展为MASH相关肝硬化和肝细胞癌。尽管肝病本身具有严重性，然而MASLD死亡原因往往与心血管疾病相关，这与其引发的代谢紊乱密切相关。因此，改善饮食结构和增加体力活动仍是当前管理MASLD的关键策略，其中运动是促进体力活动的重要方式。本综述系统总结运动干预对MASLD的影响，比较不同运动类型和干预模式的效果差异，探讨其潜在的分子机制，以期为优化MASLD的非药物治疗策略提供理论依据和实践指导。

Abstract: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become an important threat to global health, and its incidence rate is as high as 30% worldwide. MASLD covers a series of phenotypes, from simple steatosis (characterized by more than 5% lipid accumulation in hepatocytes) to fatty hepatitis (MASH) associated with metabolic dysfunction, which is accompanied by liver inflammation and/or fibrosis, and may further develop into MASH-related cirrhosis and hepatocellular carcinoma. Although the liver disease itself is serious, the main cause of death of MASLD is often related to cardiovascular disease, which is closely related to the metabolic disorder caused by it. Therefore, improving diet structure and increasing physical activity are still the key strategies to manage MASLD, in which exercise is an important way to promote physical activity. This review systematically summarizes the influence of exercise intervention on MASLD, compares the differences in effects of different exercise types and intervention modes, and discusses its potential molecular mechanism, in order to provide a theoretical basis and practical guidance for optimizing MASLD’s non-drug treatment strategy.