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肝细胞因子在代谢功能障碍相关脂肪性肝病中的研究进展

黄成雅, 杜苏苏, 郑文, 李晓南^*

南京医科大学附属儿童医院儿童保健科，南京 210008

摘要

代谢功能障碍相关脂肪性肝病(metabolic dysfunction-associated steatotic liver disease, MASLD)是由代谢功能障碍引起的脂肪在肝脏中过度堆积的疾病，导致肝脏发生脂肪变性和炎症损伤，是全球最常见的慢性肝病，其发病机制尚未完全明确。近年来研究发现，一类由肝脏细胞分泌的细胞因子即肝细胞因子在MASLD病理生理调控网络中具有生物标志物及治疗靶点的双重价值。本文总结了MASLD发生与发展的“多次打击”学说，详细阐述了胎球蛋白-A、硒蛋白P、成纤维细胞生长因子21 等肝细胞因子在糖脂代谢紊乱、氧化应激及炎症反应等病理过程中的变化水平及具体分子机制，同时总结肝细胞因子作为生物标志物在儿童早期MASLD中的临床应用前景。本文提出肝细胞因子在MASLD干预及儿童代谢异常中的潜在价值，有望成为MASLD等相关代谢性疾病早期诊断、干预及治疗的靶点。

关键词： 肥胖; 儿童肥胖; 肝细胞因子; 代谢功能障碍相关脂肪性肝病

Research progress on hepatokines in metabolic dysfunction-associated steatotic liver disease

HUANG Cheng-Ya, DU Su-Su, ZHENG Wen, LI Xiao-Nan^*

The Department of Child Health Care, Nanjing Medical University Affiliated Children's Hospital, Nanjing 210008, China

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by excessive fat accumulation in the liver resulting from metabolic dysfunction. This condition causes hepatic steatosis and inflammatory injury, representing the most common chronic liver disease globally, while its pathogenesis remains incompletely understood. Recent research has identified a class of cytokines secreted by liver cells, known as hepatokines, which hold dual value as biomarkers and therapeutic targets within the pathophysiological regulatory network of MASLD. This review summarizes the 'multiple-hit' hypothesis regarding the pathogenesis and progression of MASLD. It elaborates on the altered levels and specific molecular mechanisms of hepatokines, such as fetuin-A, selenoprotein P, and fibroblast growth factor 21 (FGF21), in pathological processes including glucolipid metabolic disorders, oxidative stress, and inflammatory responses. Furthermore, it outlines the clinical application prospects of using hepatokines as biomarkers for early-stage MASLD in children. This paper highlights the potential value of hepatokines in MASLD intervention and childhood metabolic abnormalities, proposing them as promising targets for the early diagnosis, intervention, and treatment of MASLD and related metabolic diseases.

Key words: obesity; childhood obesity; hepatokines; metabolic dysfunction-associated steatotic liver disease

收稿日期：　　录用日期：

通讯作者：李晓南　　E-mail:

DOI: 10.13294/j.aps.2026.0041

引用本文：

黄成雅, 杜苏苏, 郑文, 李晓南. 肝细胞因子在代谢功能障碍相关脂肪性肝病中的研究进展[J]. 生理学报 2026; 78 (3): 476-486.

HUANG Cheng-Ya, DU Su-Su, ZHENG Wen, LI Xiao-Nan. Research progress on hepatokines in metabolic dysfunction-associated steatotic liver disease. Acta Physiol Sin 2026; 78 (3): 476-486 (in Chinese with English abstract).