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非酒精性脂肪性肝病/非酒精性脂肪性肝炎(NAFLD/NASH)是指除外酒精和其他明确的肝损伤因素所致的以肝细胞脂肪沉积为特征的临床病理综合征。胰岛素抵抗(IR)与NAFLD/NASH的发病密切相关,因此改善IR或许可以减轻肝损伤。多项随机对照临床试验显示胰岛素增敏剂和逐渐减轻体质量(饮食疗法或体育锻炼等)对NAFLD的治疗有一定作用,但长期疗效尚不明确。本文对近年关于改善IR治疗NAFLD/NASH的临床试验作一综述。
Non-alcoholic fatty liver disease / non-alcoholic steatohepatitis (NAFLD / NASH) is a clinical pathological syndrome characterized by fatty deposits of hepatocytes due to alcohol and other specific liver injury factors. Insulin resistance (IR) is closely associated with the pathogenesis of NAFLD / NASH, so improving IR may reduce liver damage. A number of randomized controlled clinical trials have shown that insulin sensitizers and gradual weight loss (diet therapy or physical activity, etc.) have some effect on the treatment of NAFLD, but long-term efficacy is not clear. This review summarizes recent clinical trials of improving NAFLD / NASH for IR.