Die frühe Fettleber und ihre Folgen

Zusammenfassung

Die nichtalkoholische Fettleber ist stark mit Insulinresistenz, Typ-2-Diabetes und Atherosklerose assoziiert. Darüber hinaus sagt eine Fettleber die Erkrankungswahrscheinlichkeit für Typ-2-Diabetes und Atherosklerose voraus, was eine kausale Rolle der Fettleber in der Pathogenese dieser Erkrankungen impliziert. Diese Erkenntnisse beruhen vor allem auf Studien die Personen mit einem relativ hohen Grad der Leberverfettung untersuchten. Folgerichtig zielen Strategien zur Prävention und Therapie der Fettleber darauf hin, diese Menschen einzuschließen. Es gibt allerdings zunehmend Hinweise darauf, dass bereits eine frühe, moderat ausgeprägte Leberverfettung einen starken Einfluss auf den Glukose- und Lipidstoffwechsel hat. In diesem Bereich, unter 5,6 % Leberfett gemessen mit der Protonen-Magnetresonanz-Spektroskopie, spielen sich offensichtlich bereits relevante Veränderungen der Genregulation und des Lebermetabolismus ab. Die Rolle der frühen Fettleber in der Pathogenese des Typ-2-Diabetes und der Atherosklerose muss daher viel intensiver erforscht werden.

Abstract

Nonalcoholic fatty liver disease strongly associates with insulin resistance, type 2 diabetes and atherosclerosis. Moreover, fatty liver predicts type 2 diabetes and atherosclerosis, suggesting a causative role of fatty liver in the pathophysiology of these diseases. These findings come from studies mainly including subjects with a relatively high degree of hepatic steatosis. Accordingly strategies aiming at prevention and therapy of fatty liver target these individuals. However, there is increasing evidence that a low grade fatty liver already impacts on glucose and lipid metabolism. Under the cut-off liver fat 5.6 %, determined by proton magnetic resonace spectroscopy, alterations of gene regulation and liver metabolism are already operative. Thus the role of a low grade fatty liver in the pathophysiology of type 2 diabetes and atherosclerosis needs to be studied more intensively.

Schlüsselwörter

Fettleber - Diabetes - Atherosklerose - Hepatokine

Key words

Fatty liver - diabetes - atherosclerosis - hepatokines

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