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猪去氧胆酸通过肠-肝轴治疗MASLD的机制研究进展

李蕊, 沈文清^*

安徽师范大学体育学院生理生化检测与运动康复重点实验室，芜湖 241002

摘要

代谢功能障碍相关脂肪性肝病(metabolic dysfunction-associated steatotic liver disease, MASLD)是一种影响全球30%以上成年人的代谢性肝病，其患病率和死亡率还在不断升高。猪去氧胆酸(hyodeoxycholic acid, HDCA)是一种天然的次级亲水胆汁酸，也是中药猪胆粉的主要活性物质。多项研究表明HDCA可用于改善MASLD等一系列肝脏代谢性疾病，且效果可能优于二甲双胍。本文旨在深入探讨HDCA通过胆汁酸受体法尼醇X受体(farnesoid X receptor, FXR)、Takeda G蛋白耦联受体5 (Takeda G protein-coupled receptor-5, TGR5)、肝X受体(liver X receptor, LXR)以及HDCA与肠道菌群的相互作用，对肠-肝轴和其他组织中糖代谢、脂代谢和炎症反应的多重调控机制，以期为安全治疗MASLD、代谢功能障碍相关脂肪性肝炎(metabolic dysfunction-associated steatohepatitis, MASH)等肝脏代谢性疾病提供理论支撑和治疗靶点。

关键词： 猪去氧胆酸; 胆汁酸受体; 代谢功能障碍相关脂肪性肝病; 肠道菌群; 肠-肝轴

Research progress on the mechanism of hyodeoxycholic acid in the treatment of MASLD through the gut-liver axis

LI Rui, SHEN Wen-Qing^*

Key Laboratory of Physiological and Biochemical Testing and Exercise Rehabilitation, College of Physical Education, Anhui Normal University, Wuhu 241002, China

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a metabolic liver disorder affecting over 30% of the global adult population, with its prevalence and mortality rates continuing to rise. Hyodeoxycholic acid (HDCA), a natural secondary hydrophilic bile acid and the primary active component of traditional Chinese medicine Sus scrofa gallbladder powder, has been demonstrated by multiple studies to ameliorate MASLD and other hepatic metabolic disorders, potentially exhibiting superior efficacy to metformin. This review systematically discusses the multifaceted regulatory mechanisms of HDCA on glucose metabolism, lipid metabolism, and inflammatory responses in the gut-liver axis and peripheral tissues through its interactions with bile acid receptors including farnesoid X receptor (FXR), Takeda G protein-coupled receptor-5 (TGR5), liver X receptor (LXR) and with gut microbiota. The paper aims to provide theoretical foundations and therapeutic targets for the safe treatment of MASLD and metabolic dysfunction-associated steatohepatitis (MASH).

Key words: hyodeoxycholic acid; bile acid receptor; metabolic dysfunction-associated steatotic liver disease (MASLD); gut microbiota; gut-liver axis

收稿日期：　　录用日期：

通讯作者：沈文清　　E-mail:

DOI: 10.13294/j.aps.2026.0051

引用本文：

李蕊, 沈文清. 猪去氧胆酸通过肠-肝轴治疗MASLD的机制研究进展[J]. 生理学报 2026; 78 (3): 536-550.

LI Rui, SHEN Wen-Qing. Research progress on the mechanism of hyodeoxycholic acid in the treatment of MASLD through the gut-liver axis. Acta Physiol Sin 2026; 78 (3): 536-550 (in Chinese with English abstract).